Bottoms up for new Kenya alcohol law

The National Campaign Against Drug Abuse Authority (NACADA) has applauded the Alcoholic Drinks Control Bill, 2009 which legalises illicit brews but gives strict regulations under which they should be prepared and distributed.

The Bill which will also tax traditional brews seeks to ensure that the government controls all alcoholic drinks in the Kenyan market as well as monitor its contents.

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Ethanol Enhances Taurine-Activated Glycine Receptor Function

Emerging evidence suggests that taurine acts as a partial agonist on glycine receptors (GlyR) in vitro and in vivo. Ethanol acts as an allosteric modulator on the GlyR producing a leftward shift of the glycine concentration–response curve, with no enhancing effects observed at saturating glycine concentrations. However, to date, no electrophysiological studies have been performed on ethanol modulation of taurine-activated GlyR.

Wild-type α1 GlyR, or those bearing a serine-267 to isoleucine replacement (S267I), were homomerically expressed in Xenopus oocytes and voltage clamped at −70 mV. Ethanol was co-applied with varying concentrations of glycine or taurine and the enhancing effects of ethanol compared.

Ethanol potentiated glycine- and taurine-activated GlyR responses in a concentration-dependent manner. It shifted taurine and glycine concentration–response curves to the left, having no effects at saturating agonist concentrations. Chelation of zinc by tricine decreased ethanol enhancement of taurine-gated GlyR function. The S267I mutation prevented ethanol enhancement of taurine-mediated responses as previously also reported for glycine.

Ethanol modulates taurine activation of GlyR function by a mechanism similar to that of the full agonist glycine. The lack of effect of ethanol at saturating taurine concentrations provides mechanistic information on alcohol actions at the GlyR.

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Defective Translocation of PKCε in EtOH-Induced Inhibition of Mg2+ Accumulation in Rat Hepatocytes

Rats chronically fed ethanol for 3 weeks presented a marked decreased in total hepatic Mg²⁺ content and required approximately 12 days to restore Mg²⁺ homeostasis upon ethanol withdrawal. This study was aimed at investigating the mechanisms responsible for the EtOH-induced delay.

Hepatocytes from rats fed ethanol for 3 weeks (Lieber-De Carli diet—chronic model), rats re-fed a control diet for varying periods of time following ethanol withdrawal, and age-matched control rats fed a liquid or a pellet diet were used. As acute models, hepatocytes from control animals or HepG2 cells were exposed to varying doses of ethanol in vitro for 8 minutes.

Hepatocytes from ethanol-fed rats presented a marked inhibition of Mg²⁺ accumulation and a defective translocation of PKCε to the cell membrane. Upon ethanol withdrawal, 12 days were necessary for PKCε translocation and Mg²⁺ accumulation to return to normal levels. Exposure of control hepatocytes or HepG2 cells to a dose of ethanol as low as 0.01% for 8 minutes was already sufficient to inhibit Mg²⁺ accumulation and PKCε translocation for more than 60 minutes. Also in this model, recovery of Mg²⁺ accumulation was associated with restoration of PKCε translocation. The use of specific antisense in HepG2 cells confirmed the involvement of PKCε in modulating Mg²⁺ accumulation.

Translocation of PKCε isoform to the hepatocyte membrane is essential for Mg²⁺ accumulation to occur. Both acute and chronic ethanol administrations inhibit Mg²⁺ accumulation by specifically altering PKCε translocation to the cell membrane.

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Laboratory Models Available to Study Alcohol-Induced Organ Damage and Immune Variations: Choosing the Appropriate Model

The morbidity and mortality resulting from alcohol-related diseases globally impose a substantive cost to society.

To minimize the financial burden on society and improve the quality of life for individuals suffering from the ill effects of alcohol abuse, substantial research in the alcohol field is focused on understanding the mechanisms by which alcohol-related diseases develop and progress. Since ethical concerns and inherent difficulties limit the amount of alcohol abuse research that can be performed in humans, most studies are performed in laboratory animals.

This article summarizes the various laboratory models of alcohol abuse that are currently available and are used to study the mechanisms by which alcohol abuse induces organ damage and immune defects. The strengths and weaknesses of each of the models are discussed.

Integrated into the review are the presentations that were made in the symposium "Methods of Ethanol Application in Alcohol Model—How Long is Long Enough" at the joint 2008 Research Society on Alcoholism (RSA) and International Society for Biomedical Research on Alcoholism (ISBRA) meeting, Washington, DC, emphasizing the importance not only of selecting the most appropriate laboratory alcohol model to address the specific goals of a project but also of ensuring that the findings can be extrapolated to alcohol-induced diseases in humans.


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Request Reprint E-Mail: nbdsou0@uky.edu


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The Effect of Aripiprazole on Cue-Induced Brain Activation and Drinking Parameters in Alcoholics

Because the effects of alcohol and its environmental cues on brain dopamine have been implicated in the maintenance of heavy drinking, drugs that modify dopamine might be useful in reducing drinking or promoting abstinence.

The goal of the current study was to use an established brain imaging paradigm to explore the effect of aripiprazole (final dose 15 mg over a 14-day period), a dopamine stabilizer medication, on alcohol cue-induced brain activation and drinking in alcoholics.

Non-treatment-seeking alcoholics were randomly assigned aripiprazole (n = 14) or identical placebo (n = 16) and reported their alcohol use while taking study medication for 14 days before an alcohol cue-induced brain functional magnetic resonance imaging study.

In a Philips 3.0-T magnetic resonance imaging scanner, subjects were given a sip of alcohol before viewing a randomized presentation alcoholic- and nonalcoholic-beverage photographs while subjects rated their urge to drink. During photograph presentation, changes in regional brain activity were measured, and differences between viewing alcoholic beverage and nonalcoholic beverages were compared within and between groups.

Brain activity analysis revealed increased activation for placebo-treated subjects in the right ventral striatum (P < 0.005; threshold 15 voxels), while there was a blunting of activation in this area in the aripiprazole-treated subjects. Aripiprazole-treated subjects, compared with placebo-treated subjects, also had significantly less heavy drinking during the 14-day medication period.

The study provides both novel and valuable information regarding the effect of aripiprazole on cue-induced brain activation and voluntary drinking during treatment.


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Request Reprint E-Mail: myrickh@musc.edu


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Alcohol as evil – Temperance and policy

Beverage alcohol has developed indelibly different footprints in different cultures.

-Research shows, indeed, that how a culture views and appreciates alcohol impacts people's very likelihood of being addicted to it. In this context, the US and other Protestant English-speaking nations, and particularly Nordic ones, are characterized by intense binge drinking – amidst overall low consumption – leading to both social and health problems (including higher levels of alcohol-related mortality).

At the same time, these are the very nations that propose alcohol control policies worldwide, which they support with advanced epidemiologic research.

Ironically, this same research has shown how peculiar Temperance cultures’ drinking patterns are, particularly in contrast with those in Southern Europe. Yet superior-drinking cultures are ignored – even belittled – in formulating governmental alcohol policies.

This paradox is explored and laid at the feet of ingrained anti-alcohol feelings that pervade Temperance cultures.

One resulting subplot is the effort by leading Temperance journals and researchers to discourage alcohol producers and sellers from having any role in policy, and to punish and to ban researchers and social scientists in any way associated with producers and sellers.

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Request Reprint E-Mail: stanton@peele.net

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ICAP Periodic Review on Drinking and Culture

Issue 4 • May/June 2010

This Review issue features summaries of recent journal articles, reports, and books from 9 central, eastern, and southern European countries, covering the following topics: alcohol and the workplace, drinking and violence, drinking patterns in adult population, early identification and brief intervention, extreme/”binge” drinking, motivations and expectancies, road safety, and young people.

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Affective and Personality Risk and Cognitive Mediators of Initial Adolescent Alcohol Use

This study examined the role of cognitive factors--such as expectancies regarding the consequences of not drinking and perceptions of peer drinking--in mediating affective and personality-based risk associated with adolescents' decisions to initiate alcohol use.

Nondrinking high school students (N = 1,268) completed confidential surveys on adolescent attitudes and behaviors related to substance use in 2 consecutive years. Self-reported alcohol use was assessed in both years, and social anxiety, depression, sensation seeking, expectancies for not drinking, and perceived peer alcohol use were assessed in the second year.

The odds of initiation were considerably lower for students with higher expectancies for not drinking, compared with those with lower expectancies. Odds of initiation rose significantly with each additional perceived peer drink reported. Both cognitive factors mediated the relationships between social anxiety, depression, sensation seeking, and alcohol-use initiation. Beliefs regarding the consequences of not drinking and perceived peer drinking play key roles in the relationship between affective and personality styles on adolescent drinking. These cognitive differences may explain varying affective risk profiles for alcohol initiation and use during adolescence, and they can provide tools for prevention efforts.


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Request Reprint E-Mail: sanbrown@ucsd.edu



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Generational patterns of alcohol consumption: Continuity and change

In most contemporary western societies there is growing concern about rising levels of alcohol consumption, particularly by young people, even in countries, such as France, which have previously been assumed to have ‘sensible’ drinking cultures.

Recent popular and policy debates about British drinking cultures have hinted at a shift in generational attitudes towards alcohol, as well as patterns of consumption.

Previous intergenerational studies of work and care have found that in particular historical periods different normativities develop, reflecting both social and economic conditions.

In this paper, we draw on a research project about alcohol consumption conducted in an urban and rural area – including intergenerational interviews with case study families – to identify the different normativities in terms of attitudes towards and consumption of alcohol experienced by three cohort generations in their youth.

The paper then goes on to explore the patterns of both change and continuity that are evident in the interviewees' experiences.

The conclusion reflects on drivers of intergenerational change and associated health policy implications.

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Request Reprint E-Mail: g.valentine@leeds.ac.uk

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Alcohol Screening and Brief Intervention A guide for public health practitioners

The purpose of this manual is to provide public health professionals, such as health educators and community health workers, with the information, skills, and tools needed to conduct SBI so that they can help at-risk drinkers reduce their alcohol use to a safe amount or stop drinking. Using this effective intervention to reduce risky drinking can help improve the health of individuals and communities by preventing the range of negative outcomes associated with excessive alcohol use: injuries and deaths, including from motor vehicle crashes; social problems, such as violence; physical and mental illnesses; and employment, relationship, and financial problems.

This manual provides background information and practical steps for conducting SBI in a variety of public health settings, including trauma centers, emergency departments, other clinical settings, home visits, and public events. The manual provides brief descriptions of the problems associated with alcohol misuse, types of alcohol use, value of a public health approach in addressing alcohol problems, history and effectiveness of SBI, and key issues in screening and brief intervention. Guidance is given on choosing a screening tool and conducting screening. The four main steps in conducting brief interventions are described, including the purpose of each step, what to do, and suggestions for what to say. Also included is information on the most commonly used screening tools, a handout for clients, and a list of additional resources.


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Budget cuts will affect death rate, says report

The spending cuts made by the chancellor, George Osborne, in this week's budget could cause up to 38,000 extra deaths over the next decade, according to academic research published tomorrow.

Reductions in welfare payments and the 25% cut in spending across many government departments could lead to an increase in heart attacks and alcohol-related illnesses, according to analysis produced exclusively for the Guardian by an epidemiologist at Oxford University.

David Stuckler warns that the announced reduction in overall support for the long-term unemployed, disabled people and families and children, might severely impact people's health, or even cost them their lives.

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Budget crises, health, and social welfare programmes

The recession of 2008 has had profound economic consequences for many countries. How and when to reduce budget deficits was a major focus in the recent general election in the United Kingdom and continues to make headlines around the world. The new government has already begun to make large cuts in public expenditure,^{1 2} even though the UK’s projected underlying debt, as a share of gross domestic product (GDP), is less than that of other industrialised countries, it has longer than many other countries before it is required to refinance loans (table 1), and the actual deficit in 2009-10 was considerably less than expected. Leading economists have widely divergent views about whether the cuts will aid or hinder economic recovery,^{3 4} but have paid scant attention to the potential effects of reductions in health and social expenditure on population health.⁵ We examine historical data for insights into how lower levels of public spending might affect health.

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Family Member Involvement in Relapse Prevention Improves Alcohol Dependence Outcomes: A Prospective Study at an Addiction Treatment Facility in India

The aims of this study were to test if outcomes would be different when family members of alcohol-dependent individuals were included in intervention and to examine the factors associated with relapse during a 6-month follow-up period.

Ninety male participants admitted for 3 weeks at an inpatient facility in India were randomly assigned to individual relapse prevention (IRP), dyadic relapse prevention (DRP), and treatment as usual (TAU), with 30 participants in each group. In IRP, intervention was administered to the individual participant. In DRP, both the participant and a family member were included in intervention. In all three conditions, family members stayed in the facility with participants. Participants were followed up for 6 months after discharge from the treatment center.

DRP consistently performed better than TAU on all of the outcomes (reduction in quantity of alcohol, drinking days, and number of days with dysfunction in family, occupational, and financial dimensions). DRP participants also reported a significant reduction in the quantity of alcohol, drinking days, and family problems, compared with IRP.

Results of Cox regression showed that being in IRP/TAU groups, early-onset dependence (<25 years), and paternal history of alcohol dependence were associated with relapse after adjusting for baseline alcohol use and other covariates.

Findings provide evidence for the effectiveness of Western-based family-oriented intervention for alcohol-dependent patients in India; also, findings might help to alert treatment providers that some subsets of alcohol users might need more tailored interventions and rigorous monitoring during follow-up.


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Request Reprint E-Mail: prasanthin@epi.wustl.edu


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What's the damage? Negative health consequences of alcohol misuse in Wales

The results of a survey by Alcohol Concern Cymru show that many people in Wales remain ill-informed about the possible effects of alcohol on their health, and about what is sensible drinking.

Alcohol Concern Cymru commissioned a telephone survey of 1,000 drinkers in Wales. Amongst the main findings were:

Around half of respondents said they did not know the recommended daily maximum number of units of alcohol for a man or a woman

More than half were unable to correctly recall the number of units in either a standard pint of beer/lager or a standard glass of wine

Although 84% knew that liver disease was often directly linked to alcohol, 78% failed to mention the link between alcohol and cancer.

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Transition to Addiction Is Associated with a Persistent Impairment in Synaptic Plasticity

Chronic exposure to drugs of abuse induces countless modifications in brain physiology. However, the neurobiological adaptations specifically associated with the transition to addiction are unknown.

Cocaine self-administration rapidly suppresses long-term depression (LTD), an important form of synaptic plasticity in the nucleus accumbens.

Using a rat model of addiction, we found that animals that progressively develop the behavioral hallmarks of addiction have permanently impaired LTD, whereas LTD is progressively recovered in nonaddicted rats maintaining a controlled drug intake.

By making drug seeking consistently resistant to modulation by environmental contingencies and consequently more and more inflexible, a persistently impaired LTD could mediate the transition to addiction.


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Request Reprint E-Mail: olivier.manzoni@inserm.fr


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The language of motivational interviewing and feedback: Counselor language, client language, and client drinking outcomes.

Previous research has suggested that motivational interviewing (MI) may affect client language, which in turn predicts client drinking outcome.

In this study, we examined the relationship between counselor language and client language, personalized feedback and client language, and client language and client drinking outcome, in a sample of heavy-drinking college students.

MI was delivered in a single session with or without a personalized feedback report (MI with feedback [MIF]; MI only). Sessions were coded using the Motivational Interviewing Skill Code 2.1. A composite drinking outcome score was used, consisting of drinks per week, peak blood alcohol concentration, and protective drinking strategies.

We found three main results. First, in the MIF group, MI consistent counselor language was positively associated with client change talk. Second, after receiving feedback, MIF clients showed lower levels of sustain talk, relative to MI only clients. Finally, in the MIF group, clients with greater change talk showed improved drinking outcomes at 3 months, while clients with greater sustain talk showed poorer drinking outcomes.

These results highlight the relationship between counselor MI skill and client change talk, and suggest an important role for feedback in the change process.


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Request Reprint E-Mail: scott.walters@utsouthwestern.edu


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Longitudinal validation of the acquired preparedness model of drinking risk.

This paper reports on the first longitudinal test of the Acquired Preparedness (AP) model of alcoholism risk, which holds that individual differences in key personality traits influence drinking behavior by influencing alcohol-related learning (Smith and Anderson, 2001).

We studied 418 individuals making the transition to the independence of college across 3 longitudinal waves.

Each of 2 longitudinal models predicting typical drinking quantity provided support for the AP process.

In the first, drinking quantity at the end of the first year of college was predicted by positive urgency (the tendency to act rashly when experiencing extremely positive affect) at the start of college, and that predictive relationship appeared to have been mediated by expectancies that alcohol provides positive, arousing effects.

In the second, drinking quantity was predicted by negative urgency (the tendency to act rashly when experiencing extremely negative affect) at the start of college, and that relationship appeared to have been mediated by the motive to drink alcohol to cope with subjective distress.


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Request Reprint E-Mail: regan.settles@uky.edu


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Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating

This study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine whether these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-gender college student.

A random sample (N = 1,002) of undergraduates (56.9% women) completed a Web-based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-gender college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed.

Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventive interventions are discussed.


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Request Reprint E-Mail: lewisma@u.washington.edu


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Two Sides of the Same Story: Alcohol Use and HIV Risk Taking in South India

This qualitative study examines the role of alcohol in sexual risk among male migrant workers and female sex workers in two South Indian states.

Most men reported using alcohol for increased energy and courage prior to their sexual experiences and to reduce feelings of loneliness and isolation. Sex workers, on the other hand, often stated that they avoided alcohol prior to sex in order to stay alert and reduce the risk of violence. Both groups reported that drinking often increased male aggression and reduced condom use.

Research is needed to examine the prevalence of these patterns as well as factors associated with sexual risk and violence, in order to develop targeted interventions for these groups.

Future risk reduction programs may benefit from addressing safer ways of meeting the needs expressed by the participants. This may include strategies to defuse volatile situations, safe ways of improving the sexual experience, and interventions aimed at alleviating loneliness and isolation for migrants.

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Request Reprint E-Mail: Maria.Ekstrand@ucsf.edu


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Spatial Dimensions of Research on Alcohol and Sexual Risk: A Case Example from a Mumbai Study

Alcohol’s role in unprotected sex is an important issue in the spread of HIV. Research on alcohol use in many countries has found complex relationships between individual characteristics, places where people drink, and consumption patterns.

Data on drinking and leisure time activities and locations from in-person surveys with 1,239 young men aged 18–29 living in low-income communities in Mumbai, India, were analyzed. For every pair of men, an index of association measured the degree of similarity in their reported activities in specific communities.

Multidimensional scaling of the similarity matrix revealed men who engaged in similar activities in the same communities. Hierarchical grouping classified men based on their activity dimensions.

The ten groups of men, distinguished by their activities in particular communities, also differed in alcohol consumption, number of non-spousal sex partners, and level of unprotected sex.

Understanding where activities take place is important in designing venue-based interventions to reduce health risk behaviors leading to the spread of HIV/AIDS.


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Request Reprint E-Mail: ellen.cromley@icrweb.org


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The Use of Qualitative Comparative Analysis for Critical Event Research in Alcohol and HIV in Mumbai, India

In this paper we use Qualitative Comparative Analysis (QCA) in critical event analysis to identify under what conditions alcohol is necessary in contributing to unprotected sex.

The paper is based on a set of in-depth interviews with 84 men aged 18 = 29 from three typical low income communities in Mumbai who reported using alcohol and having sex with at least one nonspousal partner once or more in the 30 days prior to the interview. The interviews included narratives of critical events defined as recent (past 30–60 day) events involving sexual behavior with or without alcohol.

The paper identifies themes related to alcohol, sexuality and condom use, uses QCA to identify and explain configurations leading to protected and unprotected sex, and explains the differences.

The analysis shows that alcohol alone is not sufficient to explain any cases involving unprotected sex but alcohol in combination with partner type and contextual factors does explain unprotected sex for subsets of married and unmarried men.


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Request Reprint E-Mail: Jean.schensul@icrweb.org


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Alcohol segmentation reports

A series of four reports utilising segmentation tools to discuss alcohol have been produced by the Liverpool John Moores University (JMU) Centre for Public Health.

The reports aim to synthesise the different data sources that identify at-risk groups as well as to provide an insight into related motivations and attitudes. . . . . . .

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Addiction Research Centres and the Nurturing of Creativity The National Institute on Alcohol Abuse and Alcoholism

The aim of this paper is to present a concise account of the history, mission, structure and some recent achievements of the US National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Created by the US Congress 40 years ago, the NIAAA has evolved from an entity charged mainly with building a national system of alcoholism treatment services to one with responsibility for developing, nurturing and supporting the biomedical and behavioral science foundation necessary to reduce the significant domestic and global public health impact of alcohol use disorders.

The NIAAA is unique in that it functions both as a funding agency, supporting research at universities and other external, or 'extramural' research institutions, and is also a research institution itself, where alcohol research is carried out in-house, or 'intramurally'. Of a $450.2 million 2009 Congressional Appropriation, approximately 90% was devoted toward the former and approximately 10% towards the latter objective.

The current NIAAA Strategic Plan builds on a new organizing principle for long-range research planning, based on a life-span perspective that recognizes that human biology and behavior continue to change throughout life and changes occurring throughout the life-span affect individuals' drinking patterns as well as the decisions they may make to change their drinking habits or to seek help for alcohol use problems.

Within this framework, major efforts are currently being devoted to educating practitioners on clinically useful, science-based assessment and treatment methods that exist today, and development of personalized new treatments for tomorrow.


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


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5-HTTLPR genotype and associations with intoxication and intention to drive: results from a field study of bar patrons

The serotonin transporter promoter polymorphism (5-HTTLPR) has been linked to a number of human behavioral traits and disorders. The variants of 5-HTTLPR are commonly reported in three forms, L/L, S/L and S/S, with the latter most often associated with emotional distress and/or behavioral dysfunction. Missing from the research literature are investigations that assess event-level associations between 5-HTTLPR genotype and specific incidents of risk behavior in natural drinking settings.

This study reports associations between 5-HTTLPR, alcohol intoxication and intention to drive among young adult patrons exiting on-premise drinking establishments (i.e. bars) at night.

Self-report measures, breath alcohol concentration (BrAC) readings and saliva samples for DNA analysis were collected from 477 bar patrons. Analyses were performed on 225 patrons likely to be near their peak intoxication level for the night.

Results from a linear regression revealed that the 5-HTTLPR genotype was associated with exiting patron BrAC, after adjusting for random and fixed effects of other variables.

An interaction effect involving 5-HTTLPR and bar-sponsored drink specials also had an independent association with BrAC, suggesting that selection of price-discounted alcoholic beverages increased intoxication in patrons with an L allele.

In addition, results from logistic regression indicated that patrons with the S/S genotype were three times more likely to intend to drive a motor vehicle (after drinking on the night of study participation) compared with those with the L/L genotype.

The 5-HTTLPR genotype may play an important role in the etiology of problems associated with on-premise drinking establishments.


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


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Systemic κ-opioid receptor antagonism by nor-binaltorphimine reduces dependence-induced excessive alcohol self-administration in rats

Altered dynorphin opioid peptide systems contribute to increased ethanol self-administration during withdrawal following chronic alcohol exposure.

We previously identified that the κ-opioid receptor antagonist nor-binaltorphimine (nor-BNI) selectively reduced ethanol self-administration in dependent animals.

The purpose of this study was twofold: (1) determine whether peripherally administered nor-BNI could reduce dependence-induced ethanol self-administration and (2) confirm the selective κ-opioid effects of nor-BNI by administering it 24 hours prior to ethanol self-administration sessions occurring during acute withdrawal.

Nor-BNI decreased ethanol self-administration in ethanol-dependent animals, with no effect in nondependent animals.

Thus, the κ-opioid/dynorphin system is a viable pharmacotherapeutic target for the treatment of alcoholism.


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Request Reprint E-Mail: b_walker@wsu.edu

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Glutamatergic regulation of ghrelin-induced activation of the mesolimbic dopamine system

Recently, we demonstrated that the central ghrelin signalling system, involving the ghrelin receptor (GHS-R1A), is important for alcohol reinforcement. Ghrelin targets a key mesolimbic circuit involved in natural as well as drug-induced reinforcement, that includes a dopamine projection from the ventral tegmental area (VTA) to the nucleus accumbens.

The aim of the present study was to determine whether it is possible to suppress ghrelin's effects on this mesolimbic dopaminergic pathway can be suppressed, by interrupting afferent inputs to the VTA dopaminergic cells, as shown previously for cholinergic afferents.

Thus, the effects of pharmacological suppression of glutamatergic, orexin A and opioid neurotransmitter systems on ghrelin-induced activation of the mesolimbic dopamine system were investigated.

We found in the present study that ghrelin-induced locomotor stimulation was attenuated by VTA administration of the N-methyl-D-aspartic acid receptor antagonist (AP5) but not by VTA administration of an orexin A receptor antagonist (SB334867) or by peripheral administration of an opioid receptor antagonist (naltrexone). Intra-VTA administration of AP5 also suppressed the ghrelin-induced dopamine release in the nucleus accumbens.

Finally the effects of peripheral ghrelin on locomotor stimulation and accumbal dopamine release were blocked by intra-VTA administration of a GHS-R1A antagonist (BIM28163), indicating that GHS-R1A signalling within the VTA is required for the ghrelin-induced activation of the mesolimbic dopamine system.

Given the clinical knowledge that hyperghrelinemia is associated with addictive behaviours (such as compulsive overeating and alcohol use disorder) our finding highlights a potential therapeutic strategy involving glutamatergic control of ghrelin action at the level of the mesolimbic dopamine system.


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Request Reprint E-Mail: elisabet.jerlhag@pharm.gu.se


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Prairie voles as a novel model of socially facilitated excessive drinking

Social relationships strongly affect alcohol drinking in humans. Traditional laboratory rodents do not exhibit social affiliations with specific peers, and cannot adequately model how such relationships impact drinking. The prairie vole is a socially monogamous rodent used to study social bonds.

The present study tested the prairie vole as a potential model for the effects of social affiliations on alcohol drinking.

Same-sex adult sibling prairie voles were paired for five days, and then either separated into individual cages, or housed in pairs. Starting at the time of separation, the voles received unlimited access to alcohol in a two-bottle choice test versus water.

Pair-housed siblings exhibited higher preference for alcohol, but not saccharin, than singly housed voles. There was a significant correlation between the amount of alcohol consumed by each member of a pair when they were housed together (r = 0.79), but not when housed apart (r = 0.20).

Following automated analysis of circadian patterns of fluid consumption indicating peak fluid intake before and after the dark phase, a limited access two-hour two-bottle choice procedure was established.

Drinking in this procedure resulted in physiologically relevant blood ethanol concentrations and increased Fos immunoreactivity in perioculomotor urocortin containing neurons (but not in nucleus accumbens or central nucleus of the amygdala).

The high ethanol preference and sensitivity to social manipulation indicate that prairie voles can serve to model social influences on excessive drinking.


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Request Reprint E-Mail: ryabinin@ohsu.edu


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AERC Research Priorities 2010 – 2011

The AERC has identified the following areas of particular current interest, but would also like to receive high quality proposals in other areas of alcohol research. All proposals will be considered on their merits.

Evidence-based alcohol policy

Governments and service local commissioners /planners frequently express support for evidence-based policy to prevent and reduce alcohol-related harm. However, the processes by which scientific evidence and other factors influence the formulation of policy in this field can be opaque. The AERC invites proposals for examining these processes and finding ways in which the role of scientific evidence in policy formulation can be enhanced.

Alcohol and health inequalities

Research has shown that people from lower socio-economic groups are much more likely to suffer alcohol-related harm than those from higher socio-economic groups, although there is no evidence of a difference in consumption between these groups. The AERC invites proposals that seek to clarify and explain this apparent paradox. These could include reviews, surveys or any other relevant form of research.

Mobilising community resources

The mobilisation of community resources to prevent the development of excessive drinking or facilitate long-term recovery from alcohol dependence is frequently cited as having great potential to reduce alcohol-related harm. Unfortunately, there has been little research on this potential in the UK. The AERC invites proposals for research which examines the role of voluntary and community groups in reducing alcohol-related harm. This includes but is not limited to studies of the role and effectiveness of mutual help groups such as Alcoholics Anonymous, SMART Recovery and Moderation Management.

Read more about how to apply for an AERC grant


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Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences

Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in particular, that examine the effects of adverse childhood experiences on alcohol use.

The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables: living in a food-insecure household, living with a problem drinker, having been physically abused, and having been coerced into having sex. We controlled for age, religiosity, current schooling status, the household head's sex, living arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for males and females.

Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. At the bivariate level, all independent variables (except for coerced sex among males) were associated with the outcome variable. In general, respondents who had experienced an adverse event during childhood were more likely to report drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of self-reported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events and reported drunkenness was more pronounced for females. For both males and females there was a graded relationship between the number of adverse events experienced and the proportion reporting drunkenness.

We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.

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Culture Alcohol and Society Quarterly: Newsletter of Kirk/CAAS Collections at Brown

This newsletter is an outgrowth of a meeting held at Brown in 2002, for participants in the Kirk Collection Works-in- Progress Conference. The researchers were from the fields of literature, history, anthropology, social work, philosophy and editing, all dealing with the broad subject of alcoholism, and using the Brown Alcoholism and Addicition Studies Collections.

The goals of the newsletter are to continue to carry out the interdisciplinary interactions that grow out of the meeting, to provide a tool for reasearchers to inform and receive feedback from their colleagues about their research, and for the university to promote the Alcoholism and Addiction Studies Collections.

April - June 2009 (vol.4, no.3) (PDF)


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Should symptom frequency be factored into scalar measures of alcohol use disorder severity?

To evaluate whether weighting counts of alcohol use disorder (AUD) criteria or symptoms by their frequency of occurrence improves their association with correlates of AUD.

Design and participants Data were collected in personal interviews with a representative sample of US adults interviewed in 1991–92. Analyses were conducted among past-year drinkers (12+ drinks, n = 18 352) and individuals with past-year DSM-IV AUD (n = 2770).

Thirty-one symptom item indicators, whose frequency of occurrence was measured in eight categories, were used to create unweighted and frequency-weighted counts of DSM-IV past-year AUD symptoms and criteria. Correlates included density of familial alcoholism and past-year volume of ethanol intake, frequency of intoxication and utilization of alcohol treatment.

Although the AUD correlates were associated strongly and positively with the frequency of AUD symptom occurrence, weighting for symptom frequency did not strengthen their association consistently with AUD severity scores. Improved performance of the weighted scores was observed primarily among AUD correlates linked closely with the frequency of heavy drinking and among individuals with AUD. Criterion counts were correlated nearly as strongly as symptom counts with the AUD correlates.

Frequency weighting may add somewhat to the validity of AUD severity measures, especially those that are intended for use among individuals with AUD, e.g. in clinical settings. For studying the etiology and course of AUD in the general population, an equally effective and less time-consuming alternative to obtaining symptom frequency may be the use of unweighted criterion counts accompanied by independent measures of frequency of heavy drinking.

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

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S.F. eyes alcohol tax to recover health costs

San Francisco would be the first local government in the state to impose a booze fee intended to recover health care costs associated with alcohol abuse now covered by taxpayers.

The fee, expected to generate more than $15 million a year, would cover such expenses as ambulance transport to the emergency room for public inebriates, unreimbursed hospital and clinic services for alcohol-related accidents and diseases, and Department of Public Health-funded programs aimed at preventing and treating alcoholism.> > > > Read More

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Substance Abuse Treatment Programs for Gays and Lesbians

The extent of substance abuse disorders among the lesbian, gay, bisexual, and transgender (LGBT) population is not well known, although a variety of research studies suggest that the rates may be 20 to 30 percent—rates which are higher than in the general population. Further, the clinical issues associated with LGBT clients may vary substantially within this population and in comparison with other clients.

The National Survey of Substance Abuse Treatment Services (N-SSATS) provides information on the extent to which special programs for LGBT clients are available through the Nation’s treatment network. Two characteristics of facilities—type of ownership and primary focus of the facility—are often associated with the available mix of services. In 2008, 777 of 13,688 (or 6 percent) of surveyed facilities offered these specialized programs


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Evaluation of a Community Approach to Address Substance Abuse in Appalachia

The purpose of this study was to evaluate a conference based program designed to enable 26 Appalachian teams to create intervention plans to address substance abuse in their communities.

In March 2006, 26 Appalachian teams attended a conference to address substance abuse in their region. Teams of four to seven stakeholders generated community plans. The teams were evaluated 8 months later using a framework based on an adaptation of the Health Belief Model. Team leaders participated in structured telephone interviews.

Results of this study found that the most common benefit to promulgating plans was community support. The most indicated barrier was time. The majority of teams believed that their community was susceptible to substance abuse problems. The cues that were most responsible for action were public awareness campaigns that emphasized the problems associated with substance abuse. The common denominator for team success was the ability to recruit key stakeholders and the ability to integrate with other organizations.

The results of this study suggest that substance abuse is a threat to the health of the region. More effort on the part of communities will be needed to solve this problem. It will not be solved by a single agency, philosophy or program strategy, but must include multiple stakeholder participation.


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Request Reprint E-Mail: dunn@etsu.edu



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15th Annual Mark Keller Lecture - October 26, 2010

Event:	15th Annual Mark Keller Lecture on "Alcohol and the Brain: From Molecules to Humans"
Location:	Lipsett Amphitheater NIH Clinical Center (Bldg. 10) Bethesda, MD
Start Date:	10/26/2010 1:30 PM
End Date:	10/26/2010 3:30 PM
Event Details:	Presented by: R. Adron Harris, Ph.D. Waggoner Center for Alcohol and Addiction Research University of Texas at Austin

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Guide to Mutual Aid Resources

Welcome to Faces & Voices Guide to Mutual Aid Resources. Find out about the growing number and scope of volunteer recovery mutual aid groups. This one-stop resource is for people in or seeking recovery from addiction, their families and friends and for addiction treatment service providers and other allied service professionals. Numerous research studies have shown that mutual aid groups play a significant role in the process of recovery. Here you can learn about the many varieties of online and in-person mutual aid groups that are helping people find and sustain their recovery from addiction to alcohol and other drugs.

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Drunken deputy incidents on the rise, new Sheriff's Department report finds

As Los Angeles County sheriff’s deputies evacuated residents during last year’s Station fire, a trainee with the department noticed one of her superiors acting strangely. The deputy was stumbling, then he fell over.

He later admitted he was drinking vodka concealed in a Gatorade bottle during the deadly blaze. That incident and others are detailed in an oversight report released Tuesday that highlights the department's struggles with employees who drink on the job or whose drunkenness results in problems off the job.

Alcohol-related incidents involving department employees have increased this year, according to findings released by the Office of Independent Review. There were 33 incidents since January, more than all of last year, including several cases in which deputies were found drunk on duty.

Sheriff Lee Baca acknowledged Tuesday that the report shows the ineffectiveness of recent department efforts to crack down on drinking. In 2008, Baca announced plans to bar deputies from carrying firearms while intoxicated. . . . .

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Puberty-Dependent Sleep Regulation and Alcohol Use in Early Adolescents

Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents.

In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations.

Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships.

From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.

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Request Reprint E-Mail: S.Pieters@pwo.ru.nl

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The Moderating Effect of Religiosity on the Genetic Variance of Problem Alcohol Use

Previous studies have demonstrated that the heritability of alcohol-related phenotypes depends upon the social background in which it is measured (e.g., urbanicity, marital status, and religiosity). The aim of the current study was to identify whether religiosity moderated the genetic variance of problem alcohol use in men and women at two time points: adolescence and early adulthood.

Participants were 312 male MZ pairs, 379 female MZ pairs, 231 male DZ pairs, 235 female DZ pairs, and 275 opposite sex DZ pairs participating in the University of Colorado Center on Antisocial Drug Dependence. Religiosity was measured using the Value on Religion Scale (Jessor and Jessor, 1977), and problem alcohol use was measured using the Composite International Diagnostic Interview–Substance Abuse Module (Cottler et al., 1989). Data were analyzed using a model-fitting approach to the twin data.

In adolescence, genetic variance of problem alcohol use decreased significantly with increasing levels of religiosity in both men and women, whereas in early adulthood, religiosity did not moderate the genetic variance of problem alcohol use in either men or women.

Religiosity appears to moderate the genetic effects on problem alcohol use during adolescence, but not during early adulthood. The reduced genetic variance for problem alcohol use in adolescence may be the consequence of greater social control in adolescence than in young adulthood.

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Request Reprint E-Mail tanya.button@colorado.edu

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