Network Analysis of EtOH-Related Candidate Genes

Recently, we collected many large-scale datasets for alcohol dependence and EtOH response in five organisms and deposited them in our EtOH-related gene resource database (ERGR, http://bioinfo.mc.vanderbilt.edu/ERGR/). Based on multidimensional evidence among these datasets, we prioritized 57 EtOH-related candidate genes. To explore their biological roles, and the molecular mechanisms of EtOH response and alcohol dependence, we examined the features of these genes by the Gene Ontology (GO) term-enrichment test and network/pathway analysis. Our analysis revealed that these candidate genes were highly enriched in alcohol dependence/alcoholism and highly expressed in brain or liver tissues. All the significantly enriched GO terms were related to neurotransmitter systems or EtOH metabolic processes. Using the Ingenuity Pathway Analysis system, we found that these genes were involved in networks of neurological disease, cardiovascular disease, inflammatory response, and small molecular metabolism. Many key genes in signaling pathways were in the central position of these networks. Furthermore, our protein-protein interaction (PPI) network analysis suggested some novel candidate genes which also had evidence in the ERGR database. This study demonstrated that our candidate gene selection is effective and our network/pathway analysis is useful for uncovering the molecular mechanisms of EtOH response and alcohol dependence. This approach can be applied to study the features of candidate genes of other complex traits/phenotypes. Read Full Abstract Request Reprint E-Mail: zhongming.zhao@vanderbilt.edu ______________________________________________________

Repeated third trimester-equivalent ethanol exposure inhibits long-term potentiation in the hippocampal CA1 region of neonatal rats

Developmental ethanol exposure damages the hippocampus, causing long-lasting learning and memory deficits. Synaptic plasticity mechanisms (e.g., long-term potentiation [LTP]) contribute to synapse formation and refinement during development. We recently showed that acute ethanol exposure inhibits glutamatergic synaptic transmission and N-methyl-d-aspartate receptor (NMDAR)-dependent LTP in the CA1 hippocampal region of postnatal day (P)7–9 rats.

The objective of this study was to further characterize the effect of ethanol on LTP in the developing CA1 hippocampus during the third trimester equivalent.

To more closely model human ethanol exposure during this period, rat pups were exposed to ethanol vapor (2 or 4.5g/dL in air, serum ethanol concentrations=96.6–147.2 or 322–395.6mg/dL) from P2–9 (4h/d). Brain slices were prepared immediately after the end of the 4-h exposure on P7–9 and extracellular electrophysiological recordings were performed 1–7h later under ethanol-free conditions to model early withdrawal.

LTP was not different than group-matched controls in the 96.6–147.2mg/dL group; however, it was impaired in the 322–395.6mg/dL group. Neither α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptor (AMPAR)/NMDAR function nor glutamate release were affected in the 322–395.6mg/dL ethanol exposure group.

These data suggest that repeated in vivo exposure to elevated ethanol doses during the third trimester-equivalent period impairs synaptic plasticity, which may alter maturation of hippocampal circuits and ultimately contribute to the long-lasting cognitive deficits associated with fetal alcohol spectrum disorders.

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Request Reprint E-Mail: fvalenzuela@salud.unm.edu


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News Release - Call for action to reduce the harmful use of alcohol

For the first time, delegations from all 193 Member States of World Health Organization (WHO) reached consensus at the World Health Assembly on a resolution to confront the harmful use of alcohol -- which contributes to poor health globally, can devastate families and damage the structure of communities. . . . . . .

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Metropolitan Area Substance Abuse Treatment Admissions and Resources

This page includes links to brief reports on 27 major metropolitan areas in the U.S. Each report describes many of the characteristics of substance abuse treatment admissions such as socio-demographic characteristics, primary substances of abuse and referral sources.

The information on facilities includes an overall picture of the characteristics of the metropolitan area's facilities and the services which they provide. All information is derived from the Drug Abuse Services Information System (DASIS).

Links to further information are included in each report.

Page of Metro Briefs


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Substance Use among Asian Adults

Rates of past month alcohol use, binge alcohol use, and illicit drug use were lower among Asian adults than the national averages (39.8 vs. 55.2 percent, 13.2 vs. 24.5 percent, and 3.4 vs. 7.9 percent, respectively).

Among Asian adults, substance use varied greatly among Asian subgroups; past month binge alcohol use, for example, ranged from a high of 25.9 percent among Korean adults to a low of 8.4 percent among Chinese adults.

Among Asian adults, those who were born in the United States generally had higher rates of past month substance use than those who were not born in the United States, regardless of age.

The percentage who needed treatment for a substance use problem in the past year was lower among Asian adults than for the national average of adults (4.8 vs. 9.6 percent).

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Does binge drinking in teenagers affect their everyday prospective memory?

To examine whether teenage binge drinking has an adverse effect upon everyday prospective memory (PM).

The study utilised an existing-groups design, with alcohol group: binge drinkers vs non-binge drinkers as the independent factor, and scores on the two PM memory subscales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and the score on the Prospective Remembering Video Procedure (PRVP) as the dependent factors. Age, anxiety and depression scores, last alcohol use (in hours) and how many years spent drinking, were measured and analysed between the groups.

Each participant was tested in a laboratory setting.

An opportunity sample of 21 ‘binge drinkers’ (those drinking above 6 units for females and 8 units for males on 2 or more occasions per week) and 29 non-bingers were compared.

Self-reported everyday PM lapses were measured using the PRMQ. The PRVP was used as an objective measure of PM. Alcohol and other drug use were assessed by the University of East London Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged self-reported levels of anxiety and depression.

After controlling for age, anxiety and depression scores, last alcohol use and how many years spent drinking, there were no significant between-group differences on either the self-reported long-term or short-term PM lapses. However, binge drinkers recalled significantly fewer location-action combinations on the PRVP than non-binge drinkers.

The results of the present study suggest that binge drinking in the teenage years leads to impairments in everyday PM.


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Request Reprint E-Mail: tom.heffernan@northumbria.ac.uk


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Reduced anterior prefrontal cortex activation in young binge drinkers during a visual working memory task

Working memory (WM) is a major cognitive function that is altered by chronic alcohol consumption. This impairment has been linked to alterations in the hippocampus and prefrontal cortex (PFC). Animal and human studies have shown that the adolescent brain is more sensitive to the neurotoxic effects of alcohol than the adult brain, particularly those structures that mature late on in development, such as the hippocampus and prefrontal brain.

The aim of the present study was to assess visual working memory and its neural correlates in young university students who partake in intermittent consumption of large amounts of alcohol (binge drinkers).

A sample of 42 binge drinkers and 53 corresponding control subjects performed an identical pairs continuous performance task (IP-CPT) in a combined event-related potential (ERP) and exact low-resolution brain electromagnetic tomography (eLORETA) study.

The results revealed that, despite adequate performance, binge drinkers showed a smaller late positive component (LPC) associated with hypoactivation of the right anterior prefrontal cortex (aPFC) for matching stimuli, in comparison with control subjects.

These findings may reveal binge drinking-related functional alteration in recognition working memory processes and suggest that impaired prefrontal cortex function may occur at an early age in binge drinkers.

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Request Reprint E-Mail: alberto.crego@usc.es

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Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients

A new training to decrease attentional bias (attentional bias modification training, ABM) was tested in a randomized controlled experimental study with alcohol-dependent patients as an addition to cognitive behavioral therapy. In alcohol dependence, attentional bias has been associated with severity of alcoholism, craving, treatment outcome, and relapse.

Forty-three patients with DSM-IV diagnosis of alcohol dependence were randomly assigned to an ABM intervention or control training. The procedure consisted of five sessions in which patients were trained to disengage attention from alcohol-related stimuli (ABM condition) or in which they were trained on an irrelevant reaction-time test (control condition). We measured the effects of ABM on the visual-probe task, with stimuli that were presented in the ABM and with new stimuli. Craving was measured with the Desires for Alcohol Questionnaire. Follow-up data were gathered for overall treatment success, and relapse up to 3 months after the intervention.

ABM was effective in increasing the ability to disengage from alcohol-related cues. This effect generalized to untrained, new stimuli. There were no significant effects on subjective craving. For other outcome measures there were indications of clinically relevant effects.

Results indicate that ABM among alcohol-dependent patients was effective and that it may affect treatment progression. Large-scale trials are warranted to further investigate this new field.

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Request Reprint E-Mail: schoenmakers@ivo.nl

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Analgesic Effects of Ethanol Are Influenced by Family History of Alcoholism and Neuroticism

Although personality factors and family history of substance abuse influence how individuals experience pain and respond to analgesics, the combined effects of those factors have not been extensively studied.

The objective of this study was to consider the possible role of personality trait of neuroticism and family history of alcoholism on the experience of pain and their role in the analgesic response to an ethanolchallenge.

The analgesic effect of ethanol was mediated by an interaction between the personality trait of neuroticism and family history. Individuals with family history of alcoholism and high N scores reported significantly more analgesia on low dose of ethanol than those with low N scores. There was no difference in the analgesic response to ethanol among FHNs with low and high N scores.

These findings support the conclusion that neuroticism and family history of alcoholism both influence the analgesic response of alcohol. Individuals with high N scores and FHP have the strongest response to ethanol analgesia particularly on the low exposure to alcohol.

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Request Reprint E-Mail: Elizabeth.Ralevski@yale.edu

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Body Mass Index, Cigarette Smoking, and Alcohol Consumption and Cancers of the Oral Cavity, Pharynx, and Larynx: Modeling Odds Ratios in Pooled Case-C

Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height² (m²)).

Using data from the International Head and Neck Cancer Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of 10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis.

Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers.

Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer , while smoking odds ratios were greater for laryngeal cancer. Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cance , while BMI did not modify smoking and drinking odds ratios for laryngeal cancer

The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer.


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


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Why Might Adverse Childhood Experiences Lead to Underage Drinking Among US Youth? Findings From an Emergency Department-Based Qualitative Pilot Study

Research suggests that adverse childhood experiences (e.g., child abuse, interparental violence) predispose youth to early drinking initiation, but specifics about how and why adolescents progress from these exposures to alcohol use are not well understood.

This National Institute on Alcohol Abuse and Alcoholism supported study presents data from semistructured interviews with 22 adolescents who reported both initiating drinking ≤18 years old and ≥2 adverse childhood experiences. Data were collected in 2007 as part of a formative research effort for an emergency department-based intervention to reduce adolescent drinking.

Findings suggest that prevention initiatives for youth from challenging environments may need to do more than address conformity and social motivations for underage alcohol initiation. Study limitations are noted and future research is suggested.

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Request Reprint E-Mail: erothman@bu.edu

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Tackling problem drinking at the source

Over the past few months, politicians have been canvassing our opinions and asking for our votes. At Tesco, we don't ask our customers what they think just once every five years. They are constantly voting on our performance, day in, day out. And if we get things wrong, they will go and give their custom to our competitors.

That's why we are always consulting our customers on what they want and how we can help. Like them, we want town centres to be places where people feel safe. That's good for business. But it is also good for our staff, who often live just around the corner from where they work.

You can't turn on the television or read a newspaper without hearing or reading about binge-drinking. We know it gives rise to a serious health problem. But there is also a point about basic decency and living in a civilised society: it's not much fun, particularly if you are elderly, going out at night and encountering a group of binge drinkers.

So, we decided to ask our customers what they thought. This is what they told us. Nearly 70 per cent thought excessive drinking was one of the most serious issues facing the country, while 61 per cent were concerned about anti-social behaviour as a result of drinking. These figures ought to set the politicians thinking – they have certainly got Tesco thinking.

There isn't a simple solution and it isn't something we can tackle on our own. But we are announcing today some ideas which we hope will kick-start a proper debate and lead to some real progress.

We welcome the new Government's commitment to act on below-cost selling of alcohol and today I pledge that we will support Government-led action to make this happen across the UK. We will also support any future discussions on a minimum price for alcohol. . . . . .

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NIAAA Celebrates 40 Years of Research, Outreach

NIAAA celebrates the 40th anniversary of its founding this year with a fresh, new look and new publications that will examine the Institute's pivotal role in alcohol-related research and outreach.

The Institute also plans to host a special symposium on October 4, 2010, recognizing the anniversary. At this symposium, leaders in the field will discuss the ways in which alcohol research has evolved over the past 40 years and NIAAA's role in this progress. More information on this symposium will be available soon.

Anniversary banners that incorporate a new logo for the Institute, boldly acknowledging its 40 years, already are on display on the main campus of NIH.

NIAAA also will devote issues of its flagship publications to the milestone. A special issue of Alcohol Research & Health (AR&H) will cast a wide net over the multidisciplinary efforts involved in alcohol research and their public health impact. Further commemorating the anniversary, an Alcohol Alert will outline NIAAA's beginnings with the Hughes Act of 1970; its subsequent growth and establishment as an independent Institute in 1974; and highlights of its history, such as the first Fetal Alcohol Syndrome workshop, passage of the minimum legal drinking age laws, and the launch of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

In 40 years, NIAAA has helped the Nation evolve a more complete understanding of alcohol problems and how to prevent and treat them. The Institute has identified at-risk populations, including pregnant women and youth, and compelled the public to recognize their importance as prevention targets. It has allowed to flourish research that provides health care professionals with many perspectives on how alcohol use affects humans and how best to aim a broader cache of interventions. And it has created a landscape where investigators may pursue novel and cross-disciplinary questions that will build upon the advances in the field that NIAAA will continue to support.

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Press Release - New Global Alcohol Strategy of the WHO supports limiting the impact of alcohol marketing

On the 20th of May, the World Health Assembly passed a resolution that endorsed a Global Strategy to Reduce the Harmful Use of Alcohol. The strategy highlights the effectiveness of focusing on evidence-based policies regarding pricing, availability and marketing of alcoholic beverages. . . . . .

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The modulating effect of the androgen receptor on craving in alcohol withdrawal of men is partially mediated by leptin

We reported recently that a functional relevant CAG trinucleotide repeat of the androgen receptor influences craving of men in alcohol withdrawal. It is known to modulate serum concentrations of leptin, which affects hypothalamic appetite regulation. Its plasma levels are elevated during chronic alcohol consumption, normalize within periods of abstinence and are associated with craving.

The aim of this study was to further elucidate the role of leptin in mediating the effects of the mentioned polymorphism on craving in men undergoing alcohol withdrawal.

We included 110 male in-patients who were admitted for detoxification treatment. Each one had an established diagnosis of alcohol dependence according to the DSM-IV.

Our results show on the one hand negative associations between the number of CAG repeats and (i) leptin serum levels accounting for 60% and indirect, leptin-mediated effects (r=−0.096) accounting for 40% of the total effect. Dysregulation of sexual hormones influences human metabolism and seems to affect leptin homeostasis.

This report suggests that the investigated polymorphism mediates its effect on craving of men in alcohol withdrawal mostly through the regulation of leptin. Nevertheless future studies are needed to further explore the functionality of the androgen receptor gene in terms of craving.

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The Coalition: our programme for government

This is an historic document in British politics: the first time in over half a century two parties have come together to put forward a programme for partnership government. . . . . . .


6. CRIME AND POLICING
The Government believes that we need radical action to reform our criminal justice system. We need police forces that have greater freedom from Ministerial control and are better able to deal with the crime and anti-social behaviour that blights people’s lives, but which are much more accountable to the public they serve.

• We will ban the sale of alcohol below cost price.

• We will review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries.

• We will overhaul the Licensing Act to give local authorities and the police much stronger powers to remove licences from, or refuse to grant licences to, any premises that are causing problems.

• We will allow councils and the police to shut down permanently any shop or bar found to be persistently selling alcohol to children.

• We will double the maximum fine for under-age alcohol sales to £20,000.

• We will permit local councils to charge more for late-night licences to pay for additional policing.


Read Full Report (PDF)

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Media Release - Official papers support lowered adult drink drive limit

Ministry of Transport documents, released under the Official Information Act to the New Zealand Drug Foundation, show that Cabinet has no good reason to keep the adult drink drive limit (Blood Alcohol Content - BAC) at 0.08.

This month Cabinet will decide whether to lower the adult drink drive limit as part of the Government’s “Safer Journeys” road safety strategy.

. . . . . .

Read Full Release

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4th European Alcohol Policy Conference

After three successful conferences in 2004 (Warsaw), in 2006 (Helsinki) and 2008 (Barcelona), Eurocare has chosen the capital of the EU to hold the 4th European Alcohol Policy Conference with the aim of involving a wider audience.

Under the heading “From Capacity to Action”, the conference will seek to stimulate action in alcohol policy. To that end, it will bring together highly reputed experts in the alcohol field and policy makers from the national, EU and global levels to analyse why Europe has not got to grips with alcohol and the consequences this is having in third countries.

The conference is organized by Eurocare (European Alcohol Policy Alliance) under the patronage of Her Royal Highness Princess Astrid of Belgium and it is co-financed by the European Commission and co-sponsored by the WHO (World Health Organization). . . . . . .

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Press Release - Eurocare welcomes the adoption of Global Alcohol Strategy by the WHO

At its sixty-third World Health Assembly, the 193 Member States of the World Health Organization have adopted, in a consensus vote, the eagerly awaited Global Strategy to Reduce the Harmful Use of Alcohol.

In the two-hour long debate at the Assembly, all member states acknowledged the harmful use of alcohol as a major public health issue. In the many member state interventions, delegates pointed to the global aspects of the problem and requested that alcohol problems receive a higher priority at the WHO and that more resources be allocated to address those problems and to implement the new global strategy.

The important concerns identified in the debate included the increasing culture of binge drinking among young people worldwide, and the expanding influence of the alcohol marketing and advertising. Delegates welcomed the varied evidence-based measures included in the strategy and their potential for successfully addressing alcohol problems.

The resolution was adopted with one amendment proposed by Thailand on behalf of the SEARO countries asking for adequate financial and human resources for implementation (inserted in par. 4 (1)) . . . . .

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L&S Program Asks Students to Bring Their Genes to Cal

Going to college is always a test of who you are, but never more literally so than it will be next fall. Freshmen in the College of Letters and Science will have the opportunity to find out what they’re made of — genetically speaking — courtesy of the College’s “On the Same Page” program. Until now, the program asked new students to read a new book or watch a film that would give them something to talk about for the rest of the year. This time, On the Same Page takes a bold step in a different direction to explore one of the most exciting, cutting-edge areas of modern science: personalized medicine. What’s more, it will give students a rare chance to experience it on their own.

The welcoming package for incoming students will contain what might look like an absurdly simple and low-tech gadget: a cotton swab. Those who choose to use it, however, will send it back anonymously with a tiny sample of DNA off the inside of their cheeks. The resulting personal genetic analysis will unlock mysteries hidden in three of their genes.

"Understanding the impact of the variation in each of our genomes is the defining challenge for human biology for this century," said Professor Jasper Rine, who is leading the program and will present a special lecture on September 13 in Wheeler Auditorium. Rine is the Howard Hughes Professor and Professor of Genetics, Genomics and Development.

The genetic analysis to be performed as part of the program will unveil information about three non-threatening genetic factors affecting our health: the ability to absorb folic acid, to tolerate alcohol, and to metabolize lactose. These particular genes were chosen because the health issues they control are all amenable to easy solutions should any of the tests come back positive. The knowledge thus gained can serve to arm students with information to improve their health and wellbeing. . . . . . .

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Coalition Government outlines alcohol plans

The new Government has outlined its plans for alcohol policy in its latest document 'The coalition: our programme for government' [pdf]. It states:

• We will ban the sale of alcohol below cost price.
• We will review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries.
• We will overhaul the Licensing Act to give local authorities and the police much stronger powers to remove licences from, or refuse to grant licences to, any premises that are causing problems.
• We will allow councils and the police to shut down permanently any shop or bar found to be persistently selling alcohol to children.
• We will double the maximum fine for under-age alcohol sales to £20,000.
• We will permit local councils to charge more for late-night licences to pay for additional policing.

Read More

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A Global Alcohol Strategy adopted by the World Health Assembly

The World Health Assembly passed on the 20th of May a resolution endorsing a Global Strategy to Reduce the Harmful Use of Alcohol. It was a very interesting discussion in the Assembly where some 35 member states spoke - all in favour of the strategy. Three NGOs/civil society alliances also made statements supporting the resolution. . . . . . .

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High-density lipoprotein subclasses are a potential intermediary between alcohol intake and reduced risk of cardiovascular disease: The Rancho Bernard

We conducted a cross-sectional study of NMR-derived HDL subclasses and alcohol intake among 2171 community-dwelling older adults with a large proportion of daily or near-daily alcohol consumers (44 %).

We aimed to assess whether, in addition to increasing total HDL, alcohol may induce a beneficial shift in HDL particle size distribution.

Participants were categorised based on reported alcohol intake (g per week) and on frequency (none, < 3 times/week, 3–4 times/week, ≥ 5 times/week). The association between alcohol intake and lipoprotein fractions was examined using sex-specific linear regression models adjusted for age, BMI, diabetes, current smoking, exercise and hormone therapy in women.

There was a stepwise gradient with the highest weekly alcohol consumption associated with the highest total HDL size and greatest number of medium and large HDL particles, as well as higher total HDL concentrations (all P < 0·001); total small HDL did not differ.

Alcohol–HDL size associations were similar in both sexes and did not differ by use of hormone replacement therapy in women.

In conclusion, regular alcohol consumers had a higher number and percentage of large HDL particles than non-drinkers. These results suggest that one way that alcohol may decrease CVD is through potentially favourable changes in lipoprotein subclass composition.


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Request Reprint E-Mail: ebarrettconnor@ucsd.edu


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WHO to tackle alcohol misuse, binge drinking

Health ministers agreed on Thursday to try to curb binge drinking and other growing forms of excessive alcohol use through higher taxes on alcoholic drinks and tighter marketing regulations.

The global strategy to reduce the harmful use of alcohol was adopted by consensus at the annual assembly of the World Health Organisation (WHO). . . . . .

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Fetal Alcohol Spectrum Disorders: Growing Awareness in Europe

Wednesday through Friday, November 3 to 5, 2010

The aim of this conference is to bring together European researchers, public health workers, and FAS-related NGOs for the first time in order to share knowledge and promote collaborations. Presentations will cover latest developments worldwide, with an emphasis on European experience:

* Latest research on FASD in Europe
* Public health and preventions
* Diagnosis and intervention
* Consequences for justice and politics

More Conference Information

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EUROPEAN ALCOHOL AND HEALTH FORUM

6th Plenary meeting
BRUSSELS, 11 March 2010

SUMMARY REPORT

1. Welcome

�� The Chair welcomed all participants (cf. List in Annex 1). He highlighted that with a new Commissioner in place, alongside a new European Parliament, there would now be a political conversation at EU level that will have implications for public health. The political conversation will revisit issues such as subsidiarity and roles of regulation versus self regulation. He referred also to the current situation of "crisis and austerity" and the need to focus on the essentials rather than the 'nice to haves'.

�� He highlighted that an evaluation of the Nutrition Platform is on-going and that there will also be an evaluation of the Alcohol Forum.

�� The Chair proposed to reorder the morning's points to take the monitoring and commitments issue first, before moving on to the discussion on the Open Forum.

�� The Chair agreed that Members could circulate documents that relate to House of Commons Health Committee report which was circulated as a background report to this meeting.

�� With the change in the order of points above, the Agenda was approved.


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Factors Associated with Favorable Drinking Outcome 12 Months After Hospitalization in a Prospective Cohort Study of Inpatients with Unhealthy Alcohol

Prevalence of unhealthy alcohol use among medical inpatients is high.

To characterize the course and outcomes of unhealthy alcohol use, and factors associated with these outcomes.

At baseline and 12 months later, consumption and alcohol-related consequences were assessed. The outcome of interest was a favorable drinking outcome at 12 months (abstinence or drinking “moderate” amounts without consequences). The independent variables evaluated included demographics, physical/sexual abuse, drug use, depressive symptoms, alcohol dependence, commitment to change (Taking Action), spending time with heavy-drinking friends and receipt of alcohol treatment (after hospitalization). Adjusted regression models were used to evaluate factors associated with a favorable outcome.

Thirty-three percent had a favorable drinking outcome 1 year later. Not spending time with heavy-drinking friends [adjusted odds ratio (AOR) 2.14, 95% CI: 1.14–4.00] and receipt of alcohol treatment [AOR (95% CI): 2.16(1.20–3.87)] were associated with a favorable outcome. Compared to the first quartile (lowest level) of Taking Action, subjects in the second, third and highest quartiles had higher odds of a favorable outcome [AOR (95% CI): 3.65 (1.47, 9.02), 3.39 (1.38, 8.31) and 6.76 (2.74, 16.67)].

Although most medical inpatients with unhealthy alcohol use continue drinking at-risk amounts and/or have alcohol-related consequences, one third are abstinent or drink “moderate” amounts without consequences 1 year later. Not spending time with heavy-drinking friends, receipt of alcohol treatment and commitment to change are associated with this favorable outcome. This can inform efforts to address unhealthy alcohol use among patients who often do not seek specialty treatment.


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Request Reprint E-Mail: Nicolas.Bertholet@chuv.ch


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Labour's 24 hour drinking laws could be scrapped

Theresa May, the Home Secretary, said she is determined to examine problems created by the ''binge-drinking culture'', including street violence and other crimes.

Speaking at the Police Federation conference, she said she opposed the 2003 Licensing Act when it was introduced by the previous administration. . . . . .

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UN General Assembly ask for High Level meeting on Non-Communicable Diseases

Thursday 13 May the UN General Assembly concluded its consideration of the agenda item 114, Follow-up to the outcome of the Millennium Summit. It passed the draft resolution A/64/L.52 introduced by the representative of Trinidad and Tobago (on behalf of the Caribbean Community). The resolution “Prevention and control of non-communicable diseases” was according to NGO reports from the meeting co-sponsored by some one hundred countries.

The resolution draws up the background by pointing to various international health documents related to non-communicable diseases. It is also recognizing “the enormous human suffering caused by non-communicable diseases” and that these diseases are leading to increasing inequalities between countries and populations, thereby threatening the achievement of the internationally agreed development goals, including the Millennium Development Goals,”

Further in the text of the resolution the General Assembly is “noting the call to consider integrating indicators to monitor the magnitude, the trend and socio-economic impact of non-communicable diseases into the Millennium Development Goals monitoring system,”

Of interest to the alcohol field is the mentioning with appreciation in the text of the various World Health Assembly resolutions and decisions. This is including the evidence-based strategies and interventions to reduce the public health problems caused by the harmful use of alcohol. The UN resolution also points to alcohol abuse as one of the prominent risk factors for non-communicable diseases. . . . . .

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Alcohol intake and endometrial cancer risk: a meta-analysis of prospective studies

Studies on alcohol intake in relation to endometrial cancer risk have produced inconsistent results.

For a meta-analysis, we identified cohort studies of alcohol and endometrial cancer by a literature search of Pub-Med and Embase up to 1 March 2010 and by searching the reference lists of relevant articles.

Seven cohort studies, including 1 511 661 participants and 6086 endometrial cancer cases, were included in the dose–response random-effect meta-regression model. Compared with non-drinkers, women drinking less than 1 drink of alcohol (13 g of ethanol) per day had a lower risk for endometrial cancer; this risk was lower by 4% (95% confidence interval (95% CI): 0.93–1.00) for consumption up to 0.5 drink per day and by 7% (95% CI: 0.85–1.02) for consumption up to 1 drink. However, we found evidence of an increased risk for endometrial cancer for intakes higher than two alcoholic drinks per day: compared with non-drinkers, the risk was higher by 14% (95% CI: 0.95–1.36) for 2–2.5 drinks per day and by 25% (95% CI: 0.98–1.58) for >2.5 drinks per day.

Our meta-analysis indicates a possible J-shaped relationship between alcohol intake and endometrial cancer risk.

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Request Reprint E-Mail: emilie.friberg@ki.se

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Alcohol consumption in Estonia and Finland: Finbalt survey 1994-2006

Alcohol consumption has been regarded as an important contributor to the high premature mortality rates. The objective of this paper was to provide an overview and comparison of alcohol consumption and its socio-demographic determinants among adults in Estonia and Finland

The study was based on a 25-64-year-old subsample of nationally representative postal cross-sectional surveys conducted in Estonia (n=10,340) and Finland (n=19,672) during 1994-2006. Abstinence, frequency, and the amount of alcohol consumed were examined. Logistic regression models were used to test the socio-demographic differences in alcohol consumption at least once a week. The effect of socio-demographic factors on pure alcohol consumed per week was calculated using linear regression.

The proportion of abstainers was 1.5 times higher among women than men in both countries. Throughout the study period, the amount of alcohol consumed per week increased for both genders in Estonia and for women in Finland, but was stable for men in Finland. In the final study year, medium risk amount of alcohol consumed per week was nearly 1.5 times higher among men in Estonia than in Finland, but about half that among women in Estonia than in Finland. Compared to ethnic majority in Estonia, alcohol consumption at least once a week was lower among men, but amount of pure alcohol drunk per week was higher among women of ethnic minority. In Finland, alcohol consumption at least once a week was more prevalent among women of ethnic minority, but the amount of pure alcohol drunk per week was lower for both gender groups of ethnic minority. Compared to married/cohabiting respondents, alcohol consumption at least once a week was less pronounced among single respondents in Finland, divorced or separated women in both countries, and widowed respondents in Estonia. Greater amount of alcohol consumed per week was more prevalent among single and divorced or separated respondents in Finland, but only among divorced or separated men in Estonia. Frequency of alcohol consumption was lower among less educated than higher educated respondents in Finland, but not in Estonia. The amount of consumed alcohol per week was higher among less educated men in Estonia, but lower among women with basic education in Finland.

Alcohol consumption has increased in Estonia and Finland. National alcohol policies should reflect findings of alcohol epidemiology in order to introduce measures that will reduce alcohol related harm in the population effectively.

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California The 2010-11 Budget: Overview of the May Revision

In the May Revision, the administration identifies a $17.9 billion gap between current-law resources and expenditures in California's 2010-11 General Fund budget. This estimate is reasonable.

In addressing the shortfall, the Legislature should reject the Governor's most drastic spending cuts, especially his proposed elimination of CalWORKs and child care funding. Alternative spending reductions could help sustain critical components of these core programs for the state's neediest families, and some of the Governor's most severe cuts could be avoided by adopting selected revenue increases.

The report also describes the Legislature's options in deciding how much education spending the state can afford in this difficult budget year, when elected leaders also need to focus on longer-term policy changes that will better prepare California to cope with future economic downturns.

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• Targeted Tax Rate Increases. Finally, we have suggested the Legislature could consider targeted tax rate increases. Given the fragile state of the economy and the level of these taxes relative to other states, we discourage increasing the state’s broad–based big three taxes (personal income, sales and use, and corporation taxes) above their current levels. We have, however, suggested two proposals that would raise other tax rates while adhering to sound tax policy principles. First, many economists believe that taxes on alcohol do not fully compensate for the societal costs associated with drinking. Since alcohol tax rates have not been updated for inflation since 1991, such an adjustment could produce over $200 million of General Fund benefit. In addition, we suggest permanently aligning the VLF—currently increased temporarily under provisions of the February 2009 budget package—with local property tax rates, as it represents a tax on property.

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Variation in Nicotinic Acetylcholine Receptor Genes is Associated with Multiple Substance Dependence Phenotypes

There is shared genetic risk for dependence on multiple substances, and the nicotinic receptor gene cluster on chromosome 15 harbors multiple polymorphisms that associate to this risk.

Here, we report the results of an association study with 21 SNPs genotyped across the CHRNA5, CHRNA3, and CHRNB4 loci on chromosome 15q25.1. The sample consists of a discovery set (N=1858) of European-American and African-American (AA) families, ascertained on the basis of a sibling pair with cocaine and/or opioid dependence, and a case–control replication sample (N=3388) collected for association studies of alcohol, cocaine, and opioid dependence.

We tested the SNPs for association with lifetime cocaine, opioid, nicotine, and alcohol dependence. We replicated several previous findings, including associations between rs16969968 and nicotine dependence (P=0.002) and cocaine dependence (P=0.02), with opposite risk alleles for each substance. We observed these associations in AAs, which is a novel finding. The strongest association signal in either sample was between rs684513 in CHRNA5 and cocaine dependence (OR=1.43, P=0.0004) in the AA replication set.

We also observed two SNPs associated with alcohol dependence, that is, rs615470 in CHRNA5 (OR=0.77, P=0.0006) and rs578776 (OR=0.78, P=0.001).

The associations between CD and rs684513, AD and rs615470, and AD and rs578776 remained significant after a permutation-based correction for multiple testing.

These data reinforce the importance of variation in the chromosome 15 nicotinic receptor subunit gene cluster for risk of dependence on multiple substances, although the direction of the effects may vary across substances.


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Request Reprint E-Mail: joel.gelernter@yale.edu



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Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium

The literature has consistently reported no association between low to moderate alcohol consumption and pancreatic cancer; however, a few studies have shown that high levels of intake may increase risk.

Most single studies have limited power to detect associations even in the highest alcohol intake categories or to examine associations by alcohol type.

We analyzed these associations using 1,530 pancreatic cancer cases and 1,530 controls from the Pancreatic Cancer Cohort Consortium (PanScan) nested case–control study. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using unconditional logistic regression, adjusting for potential confounders.

We observed no significant overall association between total alcohol (ethanol) intake and pancreatic cancer risk (OR = 1.38, 95% CI = 0.86–2.23, for 60 or more g/day vs. >0 to <5 g/day).

A statistically significant increase in risk was observed among men consuming 45 or more grams of alcohol from liquor per day (OR = 2.23, 95% CI = 1.02–4.87, compared to 0 g/day of alcohol from liquor, P-trend = 0.12), but not among women (OR = 1.35, 95% CI = 0.63–2.87, for 30 or more g/day of alcohol from liquor, compared to none). No associations were noted for wine or beer intake.

Overall, no significant increase in risk was observed, but a small effect among heavy drinkers cannot be ruled out.


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Request Reprint E-Mail: d.michaud@imperial.ac.uk


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People who drink moderately 'are healthier than teetotallers'

Moderate drinkers have lower rates of heart disease, obesity and depression than people who abstain from alcohol entirely, the report indicates.

But while recent research has highlighted the health-giving properties of wine and some other alcoholic drinks, the authors of the latest study sound a note of caution.

Drinking modest amounts of alcohol does not necessarily maker you healthier, they claim.

Rather, people who enjoy alcohol without indulging to excess tend to be wealthier and more successful than average – the sort of people who look after other areas of their health.

Boris Hansel of the Pitié-Salpêtrière Hospital in Paris, who led the research, said: "Moderate alcohol intake is a powerful marker of a higher social level, superior general health status and lower cardiovascular risk.

. . . . . .

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Relationship between alcohol intake, health and social status and cardiovascular risk factors in the urban Paris-Ile-De-France Cohort: is the cardiopr

Observational studies document the inverse relationship between cardiovascular disease (CVD) and moderate alcohol intake. However, the causal role for alcohol in cardioprotection remains uncertain as such protection may be caused by confounders and misclassification.

The aim of our study was to evaluate potential confounders, which may contribute to putative cardioprotection by alcohol.

We evaluated clinical and biological characteristics, including cardiovascular (CV) risk factors and health status, of 149 773 subjects undergoing examination at our Center for CVD Prevention (The Urban Paris-Ile-de-France Cohort). The subjects were divided into four groups according to alcohol consumption: never, low (10 g/day), moderate (10–30 g/day) and high (>30 g/day); former drinkers were analyzed as a separate group.

After adjustment for age, moderate male drinkers were more likely to display clinical and biological characteristics associated with lower CV risk, including low body mass index, heart rate, pulse pressure, fasting triglycerides, fasting glucose, stress and depression scores together with superior subjective health status, respiratory function, social status and physical activity. Moderate female drinkers equally displayed low waist circumference, blood pressure and fasting triglycerides and low-density lipoprotein-cholesterol. Alcohol intake was strongly associated with plasma high-density lipoprotein-cholesterol in both sexes. Multivariate analysis confirmed that moderate and low drinkers displayed better health status than did never drinkers. Importantly, few factors were causally related to alcohol intake.

Moderate alcohol drinkers display a more favorable clinical and biological profile, consistent with lower CV risk as compared with nondrinkers and heavy drinkers. Therefore, moderate alcohol consumption may represent a marker of higher social level, superior health status and lower CV risk

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Request Reprint E-Mail: boris.hansel@psl.aphp.fr

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Approaches to Alcohol and Drugs in Scotland A Question of Architecture

The chapters of this report are structured in such a way as to bring the reader through a narrative from start to finish about how the Forum sees the alcohol and drugs policy landscape of 2008 and how it envisions it might be in 2025 if damage is to be significantly reduced.

Faced by the complexity and far reaching influences of alcohol and drug use and misuse, the Forum selected 7 key areas as the basis of a comprehensive systems mapping approach Whilst being able to integrate the technicalities of cross-cutting policies and research, this approach also lends itself to telling the story and identifying key issues in simpler terms.


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