The Financial Burden of Substance Abuse in West Virginia: The Welfare System

The cost of drug and alcohol use is astronomical in every societal sector. This report is a continuation of a series initially funded by the Federal Office of Juvenile Justice & Delinquency Prevention Block Grant Funds and administered by the WV Division of Justice and Community Services. 

The present work is funded by the U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention’s Prevention as Community Development: Projects of Regional and National Significance Grant and is the fourth in a series that examines the cost of drug and alcohol abuse to the criminal justice, healthcare, education, welfare, and workforce systems in West Virginia. 

A comprehensive report, incorporating estimates from all these sectors, will be produced at the end of the project. 

The present report attempts to capture the impact of drug and alcohol abuse on West Virginia’s child and family welfare sector, which includes the child and adult welfare system and those programs that provide income support and other social services programs to families.

For both systems, the present report estimates that, in 2009, substance abuse consumed over $95 million in West Virginia (Table 1).


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Population-Based Case-Control Study of DRD2 Gene Polymorphisms and Alcoholism

Several independent lines of evidence for genetic contributions to vulnerability to alcoholism exist. Dopamine is thought to play a major role in the mechanism of reward and reinforcement in response to alcohol. D2 dopamine receptor (DRD2) gene has been among the stronger candidate genes implicated in alcoholism. 

In this study, alcohol use was assessed in 196 randomly selected Kota individuals of Nilgiri Hills, South India. Six DRD2 SNPs were assessed in 81 individuals with alcoholism and 151 controls to evaluate the association between single nucleotide polymorphisms (SNPs) and alcoholism. 

Of the three models (dominant, recessive, and additive) tested for association between alcoholism and DRD2 SNPs, only the additive model shows association for three loci (rs1116313, TaqID, and rs2734835). 

Of six studied polymorphisms, five are in strong linkage disequilibrium forming onesingle haplotype block. 

Though the global haplotype analysis with these five SNPs was not significant, haplotype analysis using all six SNPs yielded a global P value of .033, even after adjusting for age. 

These findings support the importance of dopamine receptor gene polymorphisms in alcoholism. 

Further studies to replicate these findings in different populations are needed to confirm these results. 

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Expanding Our Understanding of Self-Help Support Groups for Substance Use Issues

Self-Help Support Groups (SHSGs) for substance use issues are recognized in current policies for their role in reducing substance use. However, these policies recognize only their therapeutic value.

This article argues that SHSGs can offer more than therapeutic advantage. This contention follows a study involving young people who were involved in a 12 Step fellowship. 

They valued group involvement for the connectedness, support, and opportunities to learn.

These findings have important policy implications, highlighting a need to broaden the scope of current policies so they reflect the array of potential benefit associated with SHSGs.

For clinicians and practitioners who are guided by social policy, this would offer an enhanced understanding of these groups, given that they are in prime position to advise clients about available options. 

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Request Reprint E-Mail: a.dadich@uws.edu.au 

Alcohol Use Disorders in Geriatrics

Alcohol use disorders cause significant morbidity and mortality in the geriatric population.

This review article begins with a hypothetical case for illustration, asking what the primary care physician could do for a geriatric patient with alcohol abuse over a course of four office visits. 

Various aspects of alcohol use disorders in the geriatric population are reviewed, such as range of alcohol use, epidemiology, medical/psychiatric impact, detection, comprehensive treatment planning, modalities of psychotherapy, medication management, and resources for clinicians/patients. 

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Request Reprint E-Mail:  kalapat@pi.cpmc.columbia.edu.  

Low–moderate prenatal alcohol exposure and risk to child behavioural development: a prospective cohort study

To examine the association of fetal alcohol exposure during pregnancy with child and adolescent behavioural development.

The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnancies (1989–91) and the 14-year follow up was conducted between 2003 and 2006.

Tertiary obstetric hospital in Perth, Western Australia.

The women in the study provided data at 18 and 34 weeks of gestation on weekly alcohol intake: no drinking, occasional drinking (up to one standard drink per week), light drinking (2–6 standard drinks per week), moderate drinking (7–10 standard drinks per week), and heavy drinking (11 or more standard drinks per week).

Longitudinal regression models were used to analyse the effect of prenatal alcohol exposure on Child Behaviour Checklist (CBCL) scores over 14 years, assessed by continuous z-scores and clinical cutoff points, after adjusting for confounders.

Their children were followed up at ages 2, 5, 8, 10 and 14 years. The CBCL was used to measure child behaviour.

Light drinking and moderate drinking in the first 3 months of pregnancy were associated with child CBCL z-scores indicative of positive behaviour over 14 years after adjusting for maternal and sociodemographic characteristics. These changes in z-score indicated a clinically meaningful reduction in total, internalising and externalising behavioural problems across the 14 years of follow up.

Our findings do not implicate light–moderate consumption of alcohol in pregnancy as a risk factor in the epidemiology of child behavioural problems.


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Request Reprint E-Mail: moniquer@ichr.uwa.edu.au 

Effects of Alcohol Portrayals in Movies on Actual Alcohol Consumption: An Observational Experimental Study

This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use, and identification with the movie actor/character were assessed as moderators. 

A two (gender) by two (movie: alcohol or no portrayal of alcohol) between-subject design was used.  

Participants watched a contemporary movie in a semi-naturalistic living room setting. 

A total of 122 same-sex, young adult dyads (ages 18-29) participated in the experiment  

Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption. 

Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption.  

Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie.

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Request Reprint E-Mail: r.koordeman@bsi.ru.nl    

The price of a drink: levels of consumption and price paid per unit of alcohol by Edinburgh's ill drinkers with a comparison to wider alcohol sales in Scotland

To compare alcohol purchasing and consumption by ill drinkers in Edinburgh with wider alcohol sales in Scotland.

377 patients with serious alcohol problems; two- thirds were inpatients with medical, surgical or psychiatric problems due to alcohol, one third were outpatients.

Last week's or typical weekly consumption of alcohol: type, brand, units (1 UK unit: 8g ethanol), purchase place and price.

Patients consumed mean 198 UK units/ week. The mean price paid per unit was £0.43 (lowest £0.09/unit) (£1 = 1.6 US$ or 1.2€) which is below the mean unit price, £0.72 paid in Scotland in 2007. Of units consumed, 70% were sold at or below £0.40/unit (midrange of price models proposed for minimum pricing legislation by the Scottish Government), and 83% at or below £0.50/unit proposed by the Chief Medical Officer of England. 

The lower the price paid per unit, the more units a patient consumed. 

A continuous increase in unit price from lower to higher social status, ranked according to the Scottish Index of Multiple Deprivation (based on postcode ), was not seen; patients residing in postcodes in the mid-quintile paid the highest price per unit.

Cheapness was commonly quoted as a reason for beverage choice; ciders especially ‘white’ cider and vodka were, at off-sales, cheapest per unit. 

Stealing alcohol or drinking alcohol substitutes was only very rarely reported.

Because patients with serious alcohol problems tend to purchase very cheap alcohol, elimination of the cheapest sales by minimum price or other legislation might reduce their consumption. It is unknown whether proposed price legislation in Scotland will encourage patients with serious alcohol problems to start stealing alcohol or drinking substitutes or will reduce the recruitment of new drinkers with serious alcohol problems and produce predicted longer term gains in health and social well-being.


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Request Reprint E-Mail:  jonathan.chick@gmail.com

Rostroventral caudate putamen involvement in ethanol withdrawal is influenced by a chromosome 4 locus

 

Physiological dependence and associated withdrawal episodes are thought to constitute a motivational force that sustains alcohol use and abuse and may contribute to relapse in dependent individuals. Although no animal model duplicates alcoholism, models for specific factors, like withdrawal, are useful for identifying potential genetic and neural determinants of liability in humans.

Previously, we identified a quantitative trait locus (QTL) and gene (Mpdz, which encodes the multi-PDZ domain protein) on chromosome 4 with a large effect on alcohol withdrawal in mice. 

Using congenic mice that confirm this QTL and c-Fos expression as a high-resolution marker of neuronal activation, we report that congenic mice show significantly less neuronal activity associated with alcohol withdrawal in the rostroventral caudate putamen (rvCP), but not other parts of the striatum, compared with background strain mice.

Moreover, bilateral rvCP lesions significantly increase alcohol withdrawal severity. 

Using retrograde (fluorogold) and anterograde (Texas Red conjugated dextran amine) tract tracing, we found that ∼25% of c-Fos immunoreactive rvCP neurons project to caudolateral substantia nigra pars reticulata (clSNr), which we previously found is crucially involved in withdrawal following acute and repeated alcohol exposure.

Our results expand upon work suggesting that this QTL impacts alcohol withdrawal via basal ganglia circuitry associated with limbic function, and indicate that an rvCP-clSNr projection plays a critical role. 

Given the growing body of evidence that the syntenic region of human chromosome 9p and human MPDZ gene are associated with alcohol abuse, our results may facilitate research on alcohol dependence and associated withdrawal in clinical populations.

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Request Reprint E-Mail:  buckk@ohsu.edu 

Drinking history, current drinking and problematic sexual experiences among university students

To estimate the prevalence of potentially harmful sexual experiences attributed to drinking in university students, their association with current drinking, and the influence of past high school binge drinking and age at first drink.

A web-based survey of undergraduates on six university campuses in New Zealand (n=2,548; response rate 63%) measured self-reported alcohol consumption and harms from own or others' drinking in the preceding four weeks, previous binge drinking and age of drinking onset.

Among drinkers during the four weeks, 5% of women and 8% of men reported unsafe sex due to drinking, 3% of women and 4% of men had sex they were unhappy about at the time, and 8% of women and 9% of men had sex they later regretted. Unwanted sexual advances due to someone else's drinking affected 21% of women and 12% of men, with 0.5% of both men and women reporting sexual assault. Current level of drinking was positively associated with all outcomes, but most strongly with unsafe sex. Binge drinking at high school and early drinking onset were also associated with each outcome, and only partly explained by current drinking.

Unsafe, unhappy and unwanted sexual experiences attributed to drinking are common at university and associated with heavier drinking, previous high school binge drinking and early drinking onset.

Despite an incomplete understanding of contributing causes, reduction in hazardous drinking among university students is likely to reduce risky and unwanted sexual experiences along with other alcohol-related harm. Strategies to reduce drinking at earlier ages are also warranted.


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Request Reprint E-Mail: jennie.connor@otago.ac.nz  

Prevalence and patterns of problematic alcohol use among Australian parents

Limited research data exists on the prevalence, and characteristics associated with parental alcohol use, particularly in Australia. 

This study aims to examine the drinking patterns of Australian parents, and to determine whether the drinking pattern differs by family type. The characteristics associated with regular parental alcohol use were also assessed.

Data from a representative sample of 23,356 Australians were analysed from the 2007 National Drug Strategy Household Survey.

The study found that parents were less likely to drink at levels defined as risky. Additionally, single mothers were more likely to report monthly and weekly binge drinking, compared to other mothers. Four predictors of risky parental alcohol use were identified: male; a current tobacco smoker; reporting higher levels of psychological distress; and lower levels of education.

Although this study found that parents were less likely to consume alcohol at risky levels, population estimates suggest a considerable number of Australian children live in households where risky parental alcohol use occurs.


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Request Reprint E-Mail:  e.maloney@unsw.edu.au  

This study provides the first step to extending the knowledge base on the prevalence of parental alcohol use which will help to inform public health policy and early intervention programs.

Plan for addiction institute splits NIH

Is alcohol a drug? Biochemically, the answer seems clear: the health effects of ethanol are well documented, as is its addictive nature. Yet culturally, politically and economically alcohol stands apart from other drugs, as does the research that has built up around it.

This conundrum has now acquired a practical urgency, thanks to a debate within the US National Institutes of Health (NIH). Should separate research institutes for drugs and alcohol be dissolved and replaced by a unified addictions institute?

"We've been talking about this for a dozen years. It's time to just do the right thing," said Harold Varmus, director of the National Cancer Institute and a proponent of the plan, at a meeting of the NIH's Scientific Management Review Board in Bethesda, Maryland, on 15 September. The board voted 12–3 to recommend dismantling the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in favour of a new entity that would house the addiction work of both, along with that of other NIH institutes. Non-addiction programmes would be moved elsewhere within the NIH.   > > > >

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Response to alcohol in women: Role of the menstrual cycle and a family history of alcoholism

The present study determined whether: (1) the response to alcohol varied as a function of menstrual cycle phase and (2) women with a paternal history of alcoholism (FHP) were less sensitive to the effects of alcohol compared to women without a family history of alcoholism (FHN).

The behavioral effects of alcohol (0.00, 0.25, and 0.75 g/kg) were evaluated in 21 FHN and 24 FHP women; each dose was tested during both the midfollicular and late luteal phases of the menstrual cycle.

Baseline negative mood was increased during the luteal phase compared to the follicular phase (increased Beck Depression scores and decreased Vigor, Arousal, and Friendly scores). 

Alcohol increased ratings of Drug Liking and Good Drug Effect more in the luteal phase than the follicular phase

FHP women had greater negative mood during the luteal phase and some of these dysphoric effects were increased by alcohol more in FHP women than FHN women. 

Alcohol impaired performance, with no group or menstrual cycle differences. However, consistent with previous studies, FHP women were less impaired by alcohol than FHN women on the balance task.

These data indicate that (1) the differences in response to alcohol across the menstrual cycle are subtle, although alcohol is liked more during the luteal phase; (2) increases in dysphoric mood during the luteal phase are more pronounced in FHP women compared to FHN women, particularly after alcohol; and (3) the differences observed in response to alcohol between FHP and FHN women are less pronounced than previously shown in men.


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Editorial - Cost analyses: requested and questioned

Writing in 1930, the Swedish economist Gunnar Myrdal was far from happy about contemporary attempts to produce a total profit and loss account of alcohol for society in the name of justifying a restrictive alcohol policy. He did not mince his words: “The problem lies in the notion of ‘society’ as an appraising and goal-setting subject... In terms of doctrinal history, cost analyses are a legacy of classical and neo-classical economic theory. Talk of “costs to society” turns the most atomistic, individualistic social theory in history into untenable, purely communist fiction… Like psychoanalysis and patented drugs, political economy gains popular ground in a way that makes all decent workers in these research fields shudder. Here lies a great cultural danger: nothing has such a frightening potential to “rationalise”, dehumanise and petrify the socio-ethical forces as these supposedly scientific and economic social summations. ” (Myrdal 1930, quoted in Österberg 1978, 47–48). According to Myrdal, such calculations are meaningless, nothing for honest researchers, and they lead political decision-makers astray.   > > > >


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JAG Alcohol and Housing briefing: findings from the 3rd Practitioners Forum

The Joint Action Group For Alcohol in London (JAG) has produced a new briefing on Alcohol & Housinghere). Sessions at the May forum covered in the briefing included:

• ‘Alcohol, homelessness and access to housing’
• ‘Drinking in the home’ including older drinkers, domestic violence and drinking within the family
• ‘Unacknowledged drinking in the home’ including specialist support for BME groups.   > > > >

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Effect of Acamprosate on Magnetic Resonance Spectroscopy Measures of Central Glutamate in Detoxified Alcohol-Dependent Individuals

Acamprosate is approved for the treatment of alcoholism, but its mechanism of action remains unclear. Results of animal studies suggest that a persistent hyperglutamatergic state contributes to the pathogenesis of alcoholism and that acamprosate may exert its actions by intervening in this process. Human translation of these findings is lacking.
 

To examine whether acamprosate modulates indices of central glutamate levels in recently abstinent alcohol-dependent patients as measured using proton nuclear magnetic resonance spectroscopy (¹H-MRS).

A 4-week, double-blind, placebo-controlled, randomized controlled experimental medicine study, with ¹H-MRS measures obtained on days 4 and 25.

An inpatient research unit at the NIH Clinical Center.

Thirty-three patients who met the DSM-IV criteria for alcohol dependence and who were admitted for medically supervised withdrawal from ongoing alcohol use.

Four weeks of acamprosate (initial oral loading followed by 1998 mg daily) or matched placebo, initiated at the time of admission.

The glutamate to creatine ratio as determined using single-voxel ¹H-MRS in the anterior cingulate. Exploratory neuroendocrine, biochemical, and behavioral outcomes were also collected, as were safety- and tolerability-related measures.

There was a highly significant suppression of the glutamate to creatine ratio across time by acamprosate (time x treatment interaction: F_1,29 = 13.5, P < .001). Cerebrospinal fluid levels of glutamate obtained in a subset of patients 4 weeks into abstinence were uncorrelated with the MRS measures and unaffected by treatment but were strongly correlated (R² = 0.48, P < .001) with alcohol dependence severity. Other exploratory outcomes, including repeated dexamethasone–corticotropin-releasing hormone tests, and psychiatric ratings were unaffected. Among tolerability measures, gastrointestinal symptoms were significantly greater in acamprosate-treated individuals, in agreement with the established profile of acamprosate.

The MRS measures of central glutamate are reduced across time when acamprosate therapy is initiated at the onset of alcohol abstinence.


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mheilig@mail.nih.gov

 

Spectrum - Volume 2, Issue 3, September 2010

1 You Are What You Eat and Drink: New Research Focuses on Alcohol and Nutrition

2 Alcohol’s Health Effects Go Beyond Hangovers

CHARTICLE
3 How Long Does It Take Alcohol Dependence To Develop?

PHOTO ESSAY
4 In the Line of Duty: How the Liver Becomes Damaged as It Degrades Alcohol

NEWS FROM THE FIELD
5 Moderate Drinkers May Live Longer Than Non-Drinkers
5 More Adults Drinking… and in Ways That Increase Risk
6 New Compound Improves Obesity-Related Health Complications
7 Half-hour Interventions Can Help Reduce Peer Violence and Alcohol Consequences Among Teens

5 QUESTIONS WITH...
7 Sam Zakhari, Ph.D.

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Press Release - 1 in 4 High School Students and Young Adults Report Binge Drinking 60 percent of high school students who drink, binge drink

More than 1 in 4 high school students and adults ages 18 to 34 engaged in a dangerous behavior known as binge drinking during the past month, according to the findings from a report by the Centers for Disease Control and Prevention. The report shows that each year more than 33 million adults have reported binge drinking, defined as having four or more drinks for women and five or more drinks for men over a short period of time, usually a couple of hours. And the report said levels of binge drinking have not declined during the past 15 years.

The CDC report found men are more than twice as likely to binge drink than women (21 percent compared to 10 percent). It said binge drinking is more common among non-Hispanic whites (16 percent of whom binge drink) than among non-Hispanic blacks, (10 percent of whom binge drink).   > > > >

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Malawi has embarked on a process to develop a new national alcohol policy. “The Malawian way” could well serve as a model for other countries!

One of the interesting features of the Malawian alcohol policy process is a series of consultation meetings with government agencies and civil society in various parts of the country. The third of these meetings was held on the 24th of September in the Chikhwawa District in the Southern part of Malawi, close to the border of Mozambique. Two more will be held later in 2010.  > > > >

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Depressive Symptoms and Alcohol Use are Genetically and Environmentally Correlated Across Adolescence

Depressive symptoms and alcohol use are frequently positively associated during adolescence. This study aimed to assess the heritability of each phenotype across adolescence; to assess potential shared liabilities; to examine changes in the nature of shared liabilities across adolescence; and to investigate potential causal relationships between depressive symptoms and alcohol use.

We studied a longitudinally assessed sample of adolescent Finnish twins (N = 1,282) to test hypotheses about genetic and environmental influences on these phenotypes within and across ages, using data from assessments at ages 12, 14, and 17.5 years.

The heritability of depressive symptoms is consistent across adolescence (~40–50%), with contributions from common and unique environmental factors.

The heritability of alcohol use varies across time (a² = .25–.44), and age 14 alcohol use is heavily influenced by shared environmental factors. Genetic attenuation and innovation were observed across waves.

Modest to moderate genetic (r_A = .26–.59) and environmental (r_C = .30–.63) correlations between phenotypes exist at all ages, but decrease over time.

Tests for causal relationships between traits differed across ages and sexes. Intrapair MZ difference tests provided evidence for reciprocal causation in girls at ages 14 and 17.5.

Formal causal models suggested significant causal relationships between the variables in both boys and girls.

The association between depressive symptoms and alcohol use during adolescence is likely due to a combination of shared genetic and environmental influences and causal influences. 

These influences are also temporally dynamic, complicating efforts to understand factors contributing to the relationship between these outcomes. 

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Request Reprint E-Mail:  aedwards5@vcu.edu    

Light drinking during pregnancy: still no increased risk for socioemotional difficulties or cognitive deficits at 5 years of age?

This study examines the relationship between light drinking during pregnancy and the risk of socioemotional problems and cognitive deficits at age 5 years.

Data from the nationally representative prospective UK Millennium Cohort Study (N=11 513) were used. Participants were grouped according to mothers' reported alcohol consumption during pregnancy: never drinker; not in pregnancy; light; moderate; heavy/binge. At age 5 years the strengths and difficulties questionnaire (SDQ) and British ability scales (BAS) tests were administered during home interviews. Defined clinically relevant cut-offs on the SDQ and standardised scores for the BAS subscales were used.

Boys and girls born to light drinkers were less likely to have high total difficulties (for boys 6.6% vs 9.6%, OR=0.67, for girls 4.3% vs 6.2%, OR=0.69) and hyperactivity (for boys 10.1% vs 13.4%, OR=0.73, for girls 5.5% vs 7.6%, OR=0.71) scores compared with those born to mothers in the not-in-pregnancy group. These differences were attenuated on adjustment for confounding and mediating factors. Boys and girls born to light drinkers had higher mean cognitive test scores compared with those born to mothers in the not-in-pregnancy group: for boys, naming vocabulary (58 vs 55), picture similarities (56 vs 55) and pattern construction (52 vs 50), for girls naming vocabulary (58 vs 56) and pattern construction (53 vs 52). Differences remained statistically significant for boys in naming vocabulary and picture similarities. 

At age 5 years cohort members born to mothers who drank up to 1–2 drinks per week or per occasion during pregnancy were not at increased risk of clinically relevant behavioural difficulties or cognitive deficits compared with children of mothers in the not-in-pregnancy group. 

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Request Reprint E-Mail: ; y.kelly@ucl.ac.uk 

Vital Signs: Binge Drinking Among High School Students and Adults — United States, 2009

CDC analyzed data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) on the prevalence of binge drinking among U.S. adults. 

Data also were analyzed from the 2009 National Youth Risk Behavior Survey (YRBS) on the prevalence of current alcohol use and binge drinking among U.S. high school students. Among U.S. adults, the prevalence of binge drinking was 15.2% among landline respondents. Binge drinking was more common among men (20.7%), persons aged 18–24 years (25.6%) and 25−34 years (22.5%), whites (16.0%), and persons with annual household incomes ≥$75,000 (19.3%).

Prevalence among high school students was 41.8% for current alcohol use, 24.2% for binge drinking, and 60.9% for binge drinking among students who reported current alcohol use.



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Cultural and Gender Convergence in Adolescent Drunkenness Evidence From 23 European and North American Countries

To investigate time-trend changes in the frequency of drunkenness among European and North American adolescents.

Cross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC).

High schools in 23 countries.

A sample of 77 586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling.

The frequency of drunkenness.

We observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls.

The confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.


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ekuntsche@sfa-ispa.ch

 

Chronic social isolation and chronic variable stress during early development induce later elevated ethanol intake in adult C57BL/6J mice

Experience with stress situations during early development can have long-lasting effects on stress- and anxiety-related behaviors. Importantly, this can also favor drug self-administration. 

These studies examined the effects of chronic social isolation and/or variable stress experiences during early development on subsequent voluntary ethanol intake in adult male and female C57BL/6J mice. 

The experiments were conducted to evaluate the effect of chronic isolation between weaning and adulthood (Experiment 1), chronic isolation during adulthood (Experiment 2), and chronic variable stress (CVS) alone or in combination with chronic social isolation between weaning and adulthood (Experiment 3) on subsequent voluntary ethanol intake. Mice were born in our facility and were separated into two housing conditions: isolate housed (one mouse/cage) or group housed (four mice/cage) according to sex. Separate groups were isolated for 40 days starting either at time of weaning postnatal day 21 (PD 21) (early isolation, Experiments 1 and 3) or at adulthood (PD 60: late isolation, Experiment 2). The effects of housing condition on subsequent ethanol intake were assessed starting at around PD 65 in Experiments 1 and 3 or PD 105 days in Experiment 2. In Experiment 3, starting at PD 32, isolate-housed and group-housed mice were either subjected to CVS or left undisturbed. CVS groups experienced random presentations of mild stressors for 14 days, including exposure to an unfamiliar open field, restraint, physical shaking, and forced swim, among others. All mice were tested for ethanol intake for 14 days using a two-bottle choice (ethanol 15% vol/vol vs. water) for a 2-h limited access procedure. 

Early social isolation resulted in greater ethanol intake compared with the corresponding group-housed mice (Experiment 1). In contrast, social isolation during adulthood (late isolation) did not increase subsequent ethanol intake compared with the corresponding group-housed mice (Experiment 2). 

For mice that did not experience CVS, early social isolation resulted in greater ethanol intake compared with group-housed mice (Experiment 3). CVS subsequently resulted in a significant increase in ethanol intake in group-housed mice, but CVS failed to further increase ethanol intake in mice that experienced chronic social isolation early in life (Experiment 3). 

Overall, female mice consumed more ethanol than males, whether isolated (early or late) or group housed. 

These results indicate that early but not late social isolation can subsequently influence ethanol consumption in C57BL/6J mice. 

Thus, the developmental timing of chronic social isolation appears to be an important factor in defining later effects on ethanol self-administration behavior. In addition, experience with CVS early in life results in elevated ethanol intake later in adulthood. 

Taken together, these results emphasize the important role of early stress experiences that modulate later voluntary ethanol intake during adulthood.

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Request Reprint E-Mail:  mailto:lopezm@musc.edu 

Gender differences in ethanol-induced behavioral sensitivity in zebrafish

Gender-related differential sensitivity to ethanol has long been recognized. Our previous studies have demonstrated that the zebrafish, an animal model used currently to study genetics and development related to a variety of human diseases, is also sensitive to pharmacologically relevant concentrations of ethanol. 

Sensitivity to ethanol in the zebrafish can be easily gauged with a simple nonintrusive behavioral test that measures ethanol-related alterations in schooling by determining the distance between each fish and its nearest neighbor. 

The purpose of this study was to determine the influence of gender on the strain-specific ethanol sensitivity that we had observed previously.

One hundred and sixty zebrafish of the wild-type (WT) and the long fin striped (LFS) strains were equally divided by gender for use in this study. For acute ethanol treatment, the fish were separated by gender and strain and exposed to 0.0, 0.125, 0.25 0.50, or 1.0% (vol/vol) ethanol. In the chronic study, eight fish of each strain and gender were exposed to 0.5% (vol/vol) ethanol for a period of 10 weeks and the swimming behavior tested before treatment and after each week of treatment.

Results showed that female WT zebrafish displayed enhanced sensitivity to the effects of chronic ethanol exposure of increased nearest neighbor distances, whereas male and female LFS fish were not significantly affected by chronic ethanol exposure.

Results of the acute ethanol study showed a dose-dependent effect in both strains and a gender effect that needs to be further investigated before enhanced female sensitivity to acute ethanol can be verified.

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Request Reprint E-Mail:  mailto:cadlugos@buffalo.edu 

The Impact of Screening, Brief Intervention and Referral for Treatment in Emergency Department Patients’ Alcohol Use: A 3-, 6- and 12-month Follow-up

This study aims to determine the impact of Screening, Brief Intervention and Referral for Treatment (SBIRT) in reducing alcohol consumption in emergency department (ED) patients at 3, 6, and 12 months following exposure to the intervention. 

Patients drinking above the low-risk limits (at-risk to dependence), as defined by National Institute of Alcohol Abuse and Alcoholism (NIAAA), were recruited from 14 sites nationwide from April to August 2004. A quasi-experimental comparison group design included sequential recruitment of intervention and control patients at each site. Control patients received a written handout. The Intervention group received the handout and participated in a brief negotiated interview with direct referral for treatment if indicated. Follow-up surveys were conducted at 3, 6, and 12 months by telephone using an Interactive Voice Response (IVR) system. 

Of the 1132 eligible patients consented and enrolled (581 control, 551 intervention), 699 (63%), 575 (52%) and 433 (38%) completed follow-up surveys via IVR at 3, 6, and 12 months, respectively. Regression analysis adjusting for the clustered sampling design and using multiple imputation procedures to account for subject attrition revealed that those receiving SBIRT reported roughly three drinks less per week than controls (B = −3.00, SE = 1.06, P < 0.05) and the level of maximum drinks per occasion was approximately three-fourths of a drink less than controls (B = -0.76, SE = 0.29, P < 0.05) at 3 months. At 6 and 12 months post-intervention, these effects had weakened considerably and were no longer statistically or substantively significant. 

SBIRT delivered by ED providers appears to have short-term effectiveness in reducing at-risk drinking, but multi-contact interventions or booster programs may be necessary to maintain long-term reductions in risky drinking. 

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Request Reprint E-Mail:   aseltine@uchc.edu

A New Test to Measure Attentional Bias and Cognitive Disinhibition in Drinkers, Based on the Hayling Task

To generate and pilot unfinished sentences, based on the Hayling Task of disinhibition, which could be completed with alcohol or non-alcohol words. To determine whether drinking habits influenced responses on the new sentences, which may advance understanding of the cognitive processes underlying alcohol-related behaviours. 

Three phases: I—Generation of appropriate sentences (via email correspondence); II—Sentence completion to establish proportion of alcohol-related and non-alcohol-related responses; III—A Hayling-style task using the sentences (laboratory-based). During the Hayling task, sentences were completed with the first word that came to mind (initiation task), and with a word that did not make semantic sense (inhibition task). In Phase III, the alcohol use disorder identification test (AUDIT) was also completed to determine whether drinking habits were related to responses. 

Fifteen sentences were generated and tested. Compared with low hazardous drinkers, higher hazardous drinkers gave more alcohol-related responses; persisted in giving alcohol responses in the inhibition task; and were slower to make non-alcohol-related responses. A positive correlation was found between AUDIT score and number of alcohol-related responses. 

A new alcohol-related sentence-completion tool, based upon the Hayling disinhibition task, was developed and piloted. Responses on the task were associated with measures of alcohol use disorders. The task can be used in research investigating the processes underlying the acute and chronic effects of alcohol, such as attentional bias and disinhibition. In future, the task could be used in conjunction with non-alcohol-related sentence completion tasks to investigate general and alcohol-specific processes of disinhibition. 

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Request Reprint E-Mail:  abi.rose@liverpool.ac.uk

Effects of Repeated Withdrawal from Alcohol on Recovery of Cognitive Impairment under Abstinence and Rate of Relapse

Several authors suggest that withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. In line with this, previous studies have demonstrated greater cognitive impairment of alcohol-dependent patients with two or more previous detoxifications (Hi-detox) compared with patients with less than two detoxifications (Lo-detox).

The aim of the present study was to investigate whether repeated withdrawal from alcohol affects recovery of cognitive function and is related to relapse.

 

Forty-eight alcohol-dependent patients (Hi-detox: n = 31, Lo-detox: n = 17) and 36 healthy controls underwent a comprehensive neuropsychological test-battery. Patients were tested after completion of detoxification (T1) and 3 (T2, n = 35) and 6 (T3, n = 28) months after discharge. Healthy controls were tested at T1 (n = 36) and T2 (n = 16). Drinking behaviour was assessed at all times.

 

Patients performed significantly worse than controls at T1 as well as T2 with regard to attention/executive function. Recovery of attention/executive function was observed within the second 3 months after discharge, but the Hi-detox group performed worse than the Lo-detox group. No association with relapse was observed.

 

This study provides first evidence, that repeated withdrawal from alcohol might be associated with reduced brain plasticity as indicated by a delay of recovery from impairment of attention/executive function. However, little evidence was found for a direct influence of cognitive impairment on treatment success. 

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Request Reprint E-Mail:  sabine.loeber@zi-mannheim.de, such@zi-mannheim.de 

Postdisaster Course of Alcohol Use Disorders in Systematically Studied Survivors of 10 Disasters

Although several studies have suggested that alcohol use may increase after disasters, it is unclear whether any apparent postdisaster increases regularly translate into new cases of alcohol use disorders.

To determine the relationship of predisaster and postdisaster prevalence of alcohol use disorders and to examine the incidence of alcohol use disorders in relation to disasters.

Data from 10 disasters, studied within the first few postdisaster months and at 1 to 3 years postdisaster, were merged and examined.

Six hundred ninety-seven directly exposed survivors of 10 disasters.

The Diagnostic Interview Schedule for DSM-III-R provided lifetime diagnoses of alcohol abuse and dependence, and onset and recency questions allowed a determination of whether the disorder had been present either prior to or following the event, or both.

While the postdisaster prevalence of alcohol use disorders was 19%, only 0.3% of the sample developed an acute new postdisaster alcohol use disorder. Most of those in recovery, however, consumed alcohol after the disaster (83%) and coped with their emotions by drinking alcohol (22%). Those with a postdisaster alcohol use disorder were more than 4 times as likely as those without to cope with their disaster-related emotions by drinking alcohol (40% vs 9%).

The vast majority of postdisaster alcohol use disorders represented the continuation or recurrence of preexisting problems. Findings suggest that those in recovery as well as those who drink to cope with their emotions represent groups warranting potential concern for postdisaster mental health intervention. Further research is needed to clarify the clinical significance of changes in alcohol use after disasters.


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Request Reprint E-Mail: carol.north@utsouthwestern.edu