Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

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Friday, December 17, 2010

Psychometric and Genetic Architecture of Substance Use Disorder and Behavioral Disinhibition Measures for Gene Association Studies



Using large twin, family, and adoption studies conducted at the Minnesota Center for Twin and Family Research, we describe our efforts to develop measures of substance use disorder (SUD) related phenotypes for targets in genome wide association analyses. 
 
Beginning with a diverse set of relatively narrow facet-level measures, we identified 5 constructs of intermediate complexity: nicotine, alcohol consumption, alcohol dependence, illicit drug, and behavioral disinhibition. 
 
The 5 constructs were moderately correlated (mean r = .57) reflecting a general externalizing liability to substance abuse and antisocial behavior. 
 
Analyses of the twin and adoption data revealed that this general externalizing liability accounted for much of the genetic risk in each of the intermediate-level constructs, though each also exhibited significant unique genetic and environmental risk. 
 
Additional analyses revealed substantial effects for age and sex, significant shared environmental effects, and that the mechanism of these shared environmental effects operates via siblings rather than parents. 
 
Our results provide a foundation for genome wide association analyses to detect risk alleles for SUDs as well as novel insights into genetic and environmental risk for SUDs. 
 
 
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Ethanol Metabolism by HeLa Cells Transduced With Human Alcohol Dehydrogenase Isoenzymes: Control of the Pathway by Acetaldehyde Concentration



Human class I alcohol dehydrogenase 2 isoenzymes (encoded by the ADH1B locus) have large differences in kinetic properties; however, individuals inheriting the alleles for the different isoenzymes exhibit only small differences in alcohol elimination rates. This suggests that other cellular factors must regulate the activity of the isoenzymes.
The activity of the isoenzymes expressed from ADH1B*1, ADH1B*2, and ADH1B*3 cDNAs was examined in stably transduced HeLa cell lines, including lines which expressed human low Km aldehyde dehydrogenase (ALDH2). The ability of the cells to metabolize ethanol was compared with that of HeLa cells expressing rat class I alcohol dehydrogenase (ADH) (HeLa-rat ADH cells), rat hepatoma (H4IIEC3) cells, and rat hepatocytes.
The isoenzymes had similar protein half-lives in the HeLa cells. Rat hepatocytes, H4IIEC3 cells, and HeLa-rat ADH cells oxidized ethanol much faster than the cells expressing the ADH1B isoenzymes. This was not explained by high cellular NADH levels or endogenous inhibitors; but rather because the activity of the β1 and β2 ADHs was constrained by the accumulation of acetaldehyde, as shown by the increased rate of ethanol oxidation by cell lines expressing β2 ADH plus ALDH2.
The activity of the human β2 ADH isoenzyme is sensitive to inhibition by acetaldehyde, which likely limits its activity in vivo. This study emphasizes the importance of maintaining a low steady-state acetaldehyde concentration in hepatocytes during ethanol metabolism.




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Alberta lifts temporary ban, allows high-alcohol beer on store shelves





In a move that has been declared a victory for "beer geeks," the Alberta government has released a new policy that will allow liquor stores to stock their shelves with high-alcohol beer.

Brews that contain more than 11.9 per cent alcohol will be taxed at a rate ­similar to spirits and coolers, the ­Alberta Gaming and Liquor ­Commission said this week.  > > > >
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Frontally mediated inhibitory processing and white matter microstructure: age and alcoholism effects



The NOGO P3 event-related potential is a sensitive marker of alcoholism, relates to EEG oscillation in the δ and θ frequency ranges, and reflects activation of an inhibitory processing network. Degradation of white matter tracts related to age or alcoholism should negatively affect the oscillatory activity within the network.
 
This study aims to evaluate the effect of alcoholism and age on δ and θ oscillations and the relationship between these oscillations and measures of white matter microstructural integrity.
 
Data from ten long-term alcoholics to 25 nonalcoholic controls were used to derive P3 from Fz, Cz, and Pz using a visual GO/NOGO protocol. Total power and across trial phase synchrony measures were calculated for δ and θ frequencies. DTI, 1.5 T, data formed the basis of quantitative fiber tracking in the left and right cingulate bundles and the genu and splenium of the corpus callosum. Fractional anisotropy and diffusivity (λL and λT) measures were calculated from each tract.
 
NOGO P3 amplitude and δ power at Cz were smaller in alcoholics than controls. Lower δ total power was related to higher λT in the left and right cingulate bundles. GO P3 amplitude was lower and GO P3 latency was longer with advancing age, but none of the time–frequency analysis measures displayed significant age or diagnosis effects.
 
The relation of δ total power at CZ with λT in the cingulate bundles provides correlational evidence for a functional role of fronto-parietal white matter tracts in inhibitory processing.




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216817 Neighborhood disadvantage amplifies risk of drug problems for residents with a family history of alcohol problems


The effects of family risk factors for alcohol and drug problems may be amplified in the context of neighborhood disadvantage. Drinkers or drug users with a family history of alcohol abuse may have fewer psychological and social resources to cope with stress associated with living in disadvantaged neighborhoods and may develop alcohol or drug problems. 

This study examined whether the relationship between family history of alcohol abuse and current alcohol or drug problems was moderated by neighborhood disadvantage. 

Survey data from the 2000 and 2005 National Alcohol Surveys (N = 11,399 adults) were linked to indicators of neighborhood disadvantage from the 2000 US Decennial Census. Neighborhoods were classified into 3 groups based on a composite indicator of neighborhood disadvantage. Past-year drug and alcohol problems included interpersonal, health, legal and work-related consequences. Individuals with both first- and second-degree relatives who were problem drinkers or alcoholics were coded as positive for family history of alcohol abuse. 

The hypothesis was tested using logistic regression adjusting for individual SES and other demographics. 

Neighborhood disadvantage did modify the association between family history and drug problems: Residents of poor neighborhoods who had a positive family history were at significantly elevated risk compared to other residents.

Neighborhood disadvantage did not modify the association between family history and alcohol problems.

The findings suggest that living in advantaged neighborhoods may reduce risk of drug problems for people with a family history of alcohol abuse, but prevention initiatives should target both advantaged and disadvantaged areas to reduce alcohol problems.



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218004 Determinants of alcohol dependence in a racially diverse sample of young men


Alcohol abuse and dependence constitute important health threats across the life course. This is particularly true among young males, who tend to have higher levels of abuse and dependence than females of all ages. 

The purpose of this study is to identify the determinants of DSM-IV alcohol abuse and dependence among young men from adolescence to young adulthood. 

Data for the study are from four waves of the National Longitudinal Study of Adolescent Health (Add Health). The sample for this study includes 4597 men who entered the panel between ages 11 and 19, and who persisted to wave 4 at ages 24 to 32. Latent growth modeling is applied to examine the patterns of alcohol abuse and dependence over time and to understand the major determinants of these patterns. 

Significant levels of alcohol-related problems are present in this sample: 27% reported at least one DSM-IV alcohol abuse symptom in the last year; 37% reported at least one DSM-IV alcohol dependence symptom, and 11% reported having three or more symptoms of alcohol dependence in the last year. 

We note substantial racial and ethnic differences, with white men drinking more and experiencing higher levels of alcohol abuse and dependence than other groups. 

Because the period from early adolescence through young adulthood includes ages typically associated with the onset of alcohol dependence, this longitudinal study will enable us to understand the determinants of the development of alcohol abuse and dependence that will have implications for prevention and treatment programs. 



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217642 Race and sex differences in age at drinking onset and development of alcohol dependence


Multiple studies have shown that risk for lifetime alcohol dependence is higher in those who initiated drinking at an earlier age; however, few studies have examined this relationship by sex and race subgroups. 

The purpose of this study is to investigate sex and race differences in age at first drink and development of alcohol dependence. 

This study uses data from Wave I of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 43,093 adults. Those meeting DSM-IV criteria for lifetime alcohol dependence (12.5%) were included in the current analyses. Linear regression was used to compare men and women and Whites, Blacks, and Hispanics on ages at first drink and onset of dependence. 

Women were significantly older than men at drinking onset (17.4 vs. 16.5, p <.001), yet there were no differences in mean age of development of alcohol dependence (24.4 vs. 23. 9, p = .140). Thus, preliminary results suggest the time course from first drink to dependence is shorter for women. 

Whites and Hispanics were significantly younger than Blacks at drinking onset (16.8, 16.7, and 17.5, p < .001) and at development of alcohol dependence (23.8, 23.8, 27.0, p < .001), demonstrating a longer time course from first drink to dependence for Blacks. 

The present study demonstrates age differences, at drinking onset as well as differences in the time lag between initiation of alcohol and development of alcohol dependence. 

The implications for the prevention of alcohol dependence are presented. 



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215026 Cohort differences in long-term patterns of change in alcohol consumption


This research aimed to estimate patterns of within-person changes in alcohol consumption among cohorts of aging adults, and assess key predictors of individual differences in alcohol use trajectories. 

Data came from 3,617 adults who were interviewed up to four times between 1986 and 2002. Multilevel multinomial logit models estimated the odds of abstinence and heavy drinking relative to moderate drinking. 

The odds of abstinence increased, and the odds of heavy drinking decreased during the study period. 

Significant cohort variations around these trends were observed, such as current older adults experiencing faster increases in abstinence than younger adults. 

However, extrapolations from these patterns suggest that current younger adults are more likely to be abstinent, and less likely to be heavy drinkers in late life than current cohorts of older adults. 

Aging-related drinking trajectories, as well as cohort differences in these patterns, are associated with time-varying health, social, and lifestyle factors. 

Drinking behavior in our aging population appears to be on a relatively promising course, perhaps reflecting the effectiveness of public health efforts to reduce drinking behavior.



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216799 Associations between income inequality and alcohol consumption patterns and problems


Income inequality contributes to poor health, but few studies have focused on inequality's relationship to health risk behaviors. 

We examined whether associations between state-level income inequality and four alcohol outcomes differed by measure of inequality or outcome, as well as whether associations were moderated by individual-level disadvantage (minority race/ethnicity, household income, neighborhood poverty). 

Survey data from 2000 and 2005 National Alcohol Surveys (N = 11,107) were linked to state-level indicators of income from the 2000 US Decennial Census. Measures of inequality were the Gini coefficient, Black-to-White poverty ratio (BWPR), and Hispanic-to-White poverty ratio (HWPR). Past-year alcohol outcomes were volume consumed during light-to-moderate-drinking occasions (1-4 drinks); volume consumed during heavy-drinking occasions (5+ drinks); interpersonal, health, legal and work-related consequences of drinking; and DSM-IV dependence. Multilevel linear and logistic regression models adjusted for individual demographics, state-level urbanicity and state-level median income. 

Main effects models showed the Gini coefficient was not related to the outcomes. 

Neither household nor neighborhood poverty moderated inequality's effects. High inequality was associated with increased light and heavy drinking by Whites, but not by Hispanics or Blacks. 

For both Blacks and Hispanics, high inequality was associated with increased risk of consequences compared to Whites. 

Findings suggest Blacks and Hispanics in areas characterized by high levels of inequality may be at particular risk for alcohol-related consequences, but this may not be due to increased consumption. 

Further examination of types of consequences experienced by Blacks and Hispanics in states with race-linked poverty are needed to reduce disparities in alcohol-related problems. 
 
 
 
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217440 Comparison of detailed drinking pattern and other characteristics between Wet, Moderate and Dry regions of the US in the National Alcohol Surveys

 
In a study utilizing data from the NSDUH and BRFSS surveys along with per capita apparent consumption estimates we categorized the US states as Wet, Moderate and Dry according to their prevalence of past month 5+ drinkers and abstainers and their per capita consumption level. States were then further categorized based on geography into six regional groups: North Central, New England, Middle Atlantic, Pacific, South Coast and Dry South. 
 
Utilizing these groupings in the National Alcohol Surveys we will provide more detailed descriptions of each regional group in terms of alcohol consumption patterns, preferences, norms, problems as well as related demographics examining other characteristics which may explain any observed differences. 
 
Such details will include contexts of drinking, estimated average drink alcohol content, the prevalence and frequency of higher levels of daily quantity such as 8+, 12+ and maximum drinks, beverage-specific measures, attitudes toward alcohol and related risk behaviors such as cigarette and illegal drug use. 
 
Analyses of these detailed measures will highlight similarities and differences between regional wetness groupings, which may suggest avenues toward understanding cultural differences in drinking and potential targets for alcohol policies aimed at reducing alcohol-related problems. 
 
 
 
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216735 Economic impact of substance abuse in Indiana



Substance abuse and addiction have a profound impact on all sectors of society. They are major contributors to a wide range of health and social problems, including domestic violence, child abuse and neglect, crime, chronic health problems, increased mortality, higher healthcare costs, and lost productivity. 

The real economic impact of substance abuse is difficult to quantify empirically because there are both direct and indirect consequences. 

In 2009, CASA released a study that measured the financial burden of substance abuse/addiction on both the nation and individual states. Since Indiana did not participate in the study, and an estimate of costs attributable to substance abuse is critical in guiding prevention planning, the State Epidemiology and Outcomes Workgroup (SEOW) decided to replicate CASA's methodology and assess Indiana's expenditures related to alcohol, tobacco, and drug abuse. We (SEOW) followed CASA's methodology whenever possible and attempted to identify federal, state, and local spending for FY 2008. In instances where we could not retrieve detailed data from state departments, we relied on the as-passed state budget. 

According to our analysis, a total of $7.3 billion in allocations can be attributed to substance abuse; representing a per-capita share of $1,145. Most of Indiana's funding is allocated to address the consequences of alcohol, tobacco, and other drug use rather than to prevent or reduce its occurrence. 

For every dollar Indiana spends on services dealing directly or indirectly with substance use, 66 cents are used for healthcare, while only 1 cent pays for prevention/intervention initiatives. 



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219205 Expenditures per drink, amounts consumed, context of drinking and alcohol-relater\d problems in the 2005 National Alcohol Survey: The policy implications


Earlier we found mean expenditures per drink of the top 10% of drinkers is lower ($0.79/drink) than the bottom 50% by volume ($4.75/drink). 

The 2005 NAS (n = 6,919), a telephone survey of US adults, asked 30-day expenditures for wine, beer and spirits and associated consumption. 

We investigated factors affecting alcohol expenditures and conversely, the role of expenditures and other factors in predicting alcohol-related problems. 

Using linear regression among current drinkers (n=3,951) we modeled expenditure per drink with demographics including gender, age, ethnicity, employment status, income, and amount consumed in on- vs. off-premise venues, plus number of social and health consequences. Alternative specifications considered the effect on number of alcohol problems of volume and mean expenditure per drink, accounting for the same influences. 

Considering results with alcohol measures that adjusted for a person's mean drink size and strength, those reporting more problems were as expected more likely to be male, younger, have lower incomes and ages, be Hispanic and not only drink higher volumes, the strongest influence, but also spent more per gram ethanol (or per self-reported drink in separate models; both ps < .01), controlling for on-premise drinking (p = .07).

While descriptively, heavier drinkers tend to pay much less per drink than lighter drinkers, once many personal characteristics are controlled, those reporting higher expenditures (willing to spend more per drink) express more alcohol related problems. 

Few general population studies have included alcohol expenditures. 

We consider data limitations and the implications for price and tax policy.




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214914 Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review



We conducted a systematic review of effects of alcohol taxes and prices on alcohol-related morbidity and mortality. 

Nine databases plus reference lists were searched for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality. Effect sizes and numerous population and study characteristics were coded. Independent estimates were combined using random effects models to obtain aggregate effect estimates. 

Fifty studies containing 340 estimates were identified. Meta-estimates were r = -0.347 for alcohol-related disease and injury outcomes, -0.022 for violence, -0.048 for suicide, -0.112 for traffic crash outcomes, -0.055 for STDs, -0.022 for other drug use, and -0.014 for crime and other misbehavior measures. All except suicide are statistically significant. 

Public policies that affect the price of alcoholic beverages have significant and substantial effects on alcohol-related disease and injury rates. 

Results suggest doubling the alcohol tax would be associated, on average, with a 35% reduction in alcohol-related mortality, 11% reduction in traffic crash deaths, 6% reduction in STDs, 2% reduction in violence, and a 1.4% reduction in crime. 


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214501 Do changes in state cigarette prices impact current, binge, and heavy drinking?



Raising prices on alcohol and tobacco products through taxation is a proven strategy to stem their respective use. As nearly 25% of the U.S. population uses alcohol and cigarettes concurrently, it is important to know whether increasing cigarette prices may impact alcohol use--a ‘cross-price effect.' 
 
This study examines the effects of changes in state cigarette prices on current, binge, and heavy drinking patterns among demographic groups. 
 
Six years of cross sectional data are pooled from the 2001-2006 Behavioral Risk Factor Surveillance System surveys (BRFSS), a nationally representative household telephone survey conducted annually with random samples of adults 18 years of age and older. 

The pooled data yield 1,698,196 independent observations. The main binary dependent variables are current smoking, and current, binge, and heavy drinking. 

The main explanatory variable is average state cigarette price, and covariates include individual demographic variables, state tobacco and alcohol policies, and economic indicators. Multivariate logistic regressions are estimated that incorporate state fixed effects. 

Preliminary findings indicate that each $1 increase in cigarette price is associated with an 8% increase in the predicted odds of drinking in the past month (p<.05) and a 7% increase in heavy drinking (p<.1). For binge drinking there was no significant effect in preliminary analyses. 

Additional analyses will be reported by demographic groups. 

Study findings will provide policy-makers with new knowledge about how potential unintended consequences of tobacco control policy may impact alcohol-related harm in different populations. 

 

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Intelligence and substance use



Why do some individuals choose to drink alcohol, smoke cigarettes, and use illegal drugs while others do not? The origin of individual preferences and values is one of the remaining theoretical questions in social and behavioral sciences. 

The Savanna-IQ Interaction Hypothesis suggests that more intelligent individuals may be more likely to acquire and espouse evolutionarily novel values than less intelligent individuals. 

Consumption of alcohol, tobacco, and drugs is evolutionarily novel, so the Savanna-IQ Interaction Hypothesis would predict that more intelligent individuals are more likely to consume these substances. 

Analyses of two large, nationally representative, and prospectively longitudinal data from the United Kingdom and the United States partly support the prediction. 

More intelligent children, both in the United Kingdom and the United States, are more likely to grow up to consume more alcohol. 

More intelligent American children are more likely to grow up to consume more tobacco, while more intelligent British children are more likely to grow up to consume more illegal drugs. 




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Sex differences in neural responses to stress and alcohol context cues


Stress and alcohol context cues are each associated with alcohol-related behaviors, yet neural responses underlying these processes remain unclear. 

This study investigated the neural correlates of stress and alcohol context cue experiences and examined sex differences in these responses. 

Using functional magnetic resonance imaging, brain responses were examined while 43 right-handed, socially drinking, healthy individuals (23 females) engaged in brief guided imagery of personalized stress, alcohol-cue, and neutral-relaxing scenarios. 

Stress and alcohol-cue exposure increased activity in the cortico–limbic–striatal circuit (P < 0.01, corrected), encompassing the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), left anterior insula, striatum, and visuomotor regions (parietal and occipital lobe, and cerebellum). 

Activity in the left dorsal striatum increased during stress, while bilateral ventral striatum activity was evident during alcohol-cue exposure. 

Men displayed greater stress-related activations in the mPFC, rostral ACC, posterior insula, amygdala, and hippocampus than women, whereas women showed greater alcohol-cue-related activity in the superior and middle frontal gyrus (SFG/MFG) than men. 

Stress-induced anxiety was positively associated with activity in emotion-modulation regions, including the medial OFC, ventromedial PFC, left superior-mPFC, and rostral ACC in men, but in women with activation in the SFG/MFG, regions involved in cognitive processing. 

Alcohol craving was significantly associated with the striatum (encompassing dorsal, and ventral) in men, supporting its involvement in alcohol “urge” in healthy men. 

These results indicate sex differences in neural processing of stress and alcohol-cue experiences and have implications for sex-specific vulnerabilities to stress- and alcohol-related psychiatric disorders.



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BMA spells out threat of industry influence


Government partnerships with tobacco, alcohol and food industries to tackle public health problems are ‘a fundamental conflict of interest’, the BMA has warned.

In evidence to the Lords science and technology select committee inquiry on behaviour change, the BMA argues that policies to control the supply of alcohol and tobacco are needed to reduce the harm they cause, and that ‘nudging’ consumers will have little effect on its own.  > > > >  Read More
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Drinking patterns in Australia, 2001-2007



This report uses data from the three most recent National Drug Household Surveys to look at trends in alcohol consumption, alcohol-related harm, alcohol beverage of choice, and under-age drinking. 

Using the 2007 data, the report also explores factors that are associated with short-term risky or high-risk drinking behaviour. 



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Media Release - THE PRICE OF GETTING HIGH, STONED AND DRUNK IN BC



A new study by UVic’s Centre for Addictions Research (CARBC) recommends ending rock bottom drink prices in government and private liquor stores to address the continuing connection between cheap alcohol, hospitalization and death in BC. 

The study also recommends giving controlled access to free alcohol for homeless problem drinkers to reduce their use of non-beverage alcohol. 

The study compares minimum prices for alcohol and illegal street drugs and shows that alcohol is by far the cheapest mood-altering drug in British Columbia.   > > > >  Read More
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Thursday, December 16, 2010

Alcohol Consumption and Health Status in Very Old Veterans



Previous research has linked drinking with health, but has yet to address alcohol consumption and the relationship between drinking and health among very old veterans. 

To help fill this gap, the authors present a cross-sectional self-report study on 1105 veterans age 90 and older who completed the national Veteran's Affairs (VA) Survey of the Health Experiences of Patients (SHEP) for fiscal year (FY) 2005. Alcohol consumption was measured using Alcohol Use Disorders Identification Test scores (AUDIT-C).1 Health status was measured using the Veterans Rand Health Survey: VR-12.2 

Among men (n = 1063), 60% were abstainers. No significant differences in mental health component (MCS; F3,1040 = 1.80, P = .15) or physical health component (PCS; F 3,1040 = 1.48, P = .22) scores were detected across consumption categories. Among women (n = 42), 47% were abstainers. 

These results suggest many very old veterans abstain from alcohol and, among men, the associations between health status and drinking observed in younger groups may not be present in very old age. 




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Opioid antagonists for alcohol dependence



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Polish Presidency Expert Conference 'Alcohol Policy in Poland and around Europe



The State Agency for Prevention of Alcohol Related Problems is organising an expert conference which will continue on the themes touched upon at the Swedish Presidency Expert Conference. It will be an opportunity to discuss the future of the Alcohol Strategy among policy makers at European, national and municipality levels as well as scientist, public health experts and representatives of the civil society. 

The main themes of the conference will include:
- alcohol and cancer
- alcohol and heart disease
- alcohol and liver
- alcohol and violence
- economic aspect of alcohol related harm 

Conference will focus on evidence based policy recommendations and recent research findings.  > > > >  Read More
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Genetic variation in the PNPLA3 gene is associated with alcoholic liver injury in caucasians



A recent genome-wide study revealed an association between variation in the PNPLA3 gene and liver fat content. In addition, the PNPLA3 single-nucleotide polymorphism rs738409 (M148I) was reported to be associated with advanced alcoholic liver disease in alcohol-dependent individuals of Mestizo descent. 

We therefore evaluated the impact of rs738409 on the manifestation of alcoholic liver disease in two independent German cohorts. 

Genotype and allele frequencies of rs738409 (M148I) were determined in 1,043 alcoholic patients with or without alcoholic liver injury and in 376 at-risk drinkers from a population-based cohort. 

Relative to alcoholic patients without liver damage (n = 439), rs738409 genotype GG was strongly overrepresented in patients with alcoholic liver cirrhosis (n = 210; OR 2.79; Pgenotype = 1.2 × 10−5; Pallelic = 1.6 × 10−6) and in alcoholic patients without cirrhosis but with elevated alanine aminotransferase levels (n = 219; OR 2.33; Pgenotype = 0.0085; Pallelic = 0.0042). The latter, biochemically defined association was confirmed in an independent population-based cohort of at-risk drinkers with a median alcohol intake of 300 g/week (OR 4.75; Pgenotype = 0.040; Pallelic = 0.022), and for aspartate aminotransferase (AST) levels. 

Frequencies of allele PNPLA3 rs738409(G) in individuals with steatosis and normal alanine aminotransferase (ALT) and AST levels were lower than in alcoholics without steatosis and normal ALT/AST (Pcombined = 0.03). 

The population attributable risk of cirrhosis in alcoholic carriers of allele PNPLA3 rs738409(G) was estimated at 26.6%. 

Genotype PNPLA3 rs738409(GG) is associated with alcoholic liver cirrhosis and elevated aminotransferase levels in alcoholic Caucasians.




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Health Survey for England - 2009: Health and lifestyles



The NHS information centre has released the latest 'Health Survey for England - 2009: Health and lifestyles'. The annual survey measures health-related behaviours and lifestyles in England including alcohol consumption, smoking and diet. On alcohol it reports:

"The current recommendations for daily alcohol intake are that it should not regularly exceed three to four units for men and two to three units for women. In the last week, 43% of men and 31% of women had drunk more than the recommended maximum on at least one day. This includes 25% of men and 15% of women who had drunk more than twice the recommended maximum.

Younger age groups and those with higher incomes were most likely to have drunk more than twice the recommended limits on at least one day in the last week."  > > > >  Read More
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An evaluation of the proposed DSM-5 alcohol use disorder criteria using Australian national data



To evaluate the proposed revisions to the DSM-IV alcohol use disorder criteria using epidemiological data.
 
Data came from the 1997 Australian National Survey of Mental Health and Well-Being. The sample consisted of 10641 participants aged 18 years and over.  

Alcohol use disorders were assessed using a revised version of the CIDI 2.0. Alcohol use disorders were assessed in all respondents who indicated that they had used alcohol more than twelve times in the previous twelve months (n=7746).  

The proposed introduction of a single alcohol use disorder was supported by CFA. DSM-5 criteria were all indicators of a single underlying disorder. Under DSM-5, the prevalence of alcohol use disorders would increase by 61.7% when compared with those diagnosed under DSM-IV. When investigating the most appropriate diagnostic threshold, the 3+ threshold maximised agreement between DSM-IV and DSM-5 diagnoses, and produced similar prevalence estimates to those yielded by DSM-IV. IRT analyses supported the removal of the Legal criterion whilst provided equivocal results for the Craving criterion.
Under the proposed DSM-IV revisions for alcohol use disorders, estimates of the prevalence in the general population would increase substantially. Whereas evidence supports some of the revisions such as a single underlying disorder, others such as the 2+ threshold for diagnosis of alcohol use disorder and the inclusion of a 'craving' criterion may be problematic.


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Impaired conditional reasoning in alcoholics: A negative impact on social interactions and risky behaviors?



To study the “social brain” in alcoholics by investigating social contract reasoning, theory of mind, and emotional intelligence.
A behavioral study comparing recently detoxified alcoholics with normal, healthy controls.
Emotional intelligence and decoding of emotional non-verbal cues have been shown to be impaired in alcoholics. This study explores whether these deficits extend to conditional reasoning about social contracts.
25 recently detoxified alcoholics (17 men and 8 women) were compared with 25 normal controls (17 men and 8 women) matched for sex, age, and education level.
Wason Selection Task investigating conditional reasoning on three different rule types (social contract, precautionary, and descriptive), Revised Reading the Mind in the Eyes Test, Trait Emotional Intelligence Questionnaire (modified version), and additional control measures.
Conditional reasoning was impaired in alcoholics. Performance on descriptive rules was not above chance. Reasoning performance was markedly better on social contract and precautionary rules, but this performance was still significantly lower than in controls. Several emotional intelligence measures were lower in alcoholics compared to controls, but these were not correlated with reasoning performance.
Conditional reasoning, including reasoning about social contracts, and emotional intelligence appear to be impaired in alcoholics. Impairment seems to be particularly severe on descriptive rules. Impairment in social contract reasoning might lead to misunderstandings and frustration in social interactions, and reasoning difficulties about precautionary rules might contribute to risky behaviors in this population.



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Number Processing in Adolescents With Prenatal Alcohol Exposure and ADHD: Differences in the Neurobehavioral Phenotype



Poor arithmetic performance is among the most sensitive outcomes associated with prenatal alcohol exposure and is also common in individuals with attention-deficit hyperactivity disorder (ADHD). 

We hypothesized that prenatal alcohol exposure would be associated with deficits in the most fundamental aspects of number processing, representation of quantity and distance, whereas ADHD would be associated with deficits in calculation, the form of number processing most dependent on attention and memory.
Two hundred and sixty-two inner-city, African American adolescents, who had been evaluated prospectively for prenatal alcohol exposure and ADHD, were assessed on a number-processing test comprised of 7 subtests.
More heavily alcohol-exposed adolescents were 4 times more likely to meet diagnostic criteria for ADHD than those whose mothers abstained from alcohol use during pregnancy. 

Two dimensions of number processing were identified in a factor analysis—magnitude comparison and calculation. As hypothesized, prenatal alcohol exposure was more strongly related to the former and ADHD to the latter. Moreover, the relation of prenatal alcohol to calculation was fully mediated by magnitude comparison, whereas the relation of ADHD to calculation was mediated by IQ but not by magnitude comparison.
These data confirm findings from previous studies identifying arithmetic as a particularly sensitive developmental endpoint for prenatal alcohol exposure. Whereas difficulties with arithmetic in ADHD are mediated by domain-general deficits in overall cognitive ability, fetal alcohol-related arithmetic difficulties are mediated primarily by a specific deficit in the core quantity system involving the ability to mentally represent and manipulate number. 

These data suggest that different interventions are likely to be effective for remediating arithmetic problems in children with prenatal alcohol exposure than in non-exposed children with ADHD.



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Amphetamine Self-Administration in Light and Moderate Drinkers



Light and moderate drinkers respond differently to the effects of abused drugs, including stimulants such as amphetamine. 

The purpose of this study was to determine whether light and moderate drinkers differ in their sensitivity to the reinforcing and subjective effects of d-amphetamine. 

We hypothesized that moderate drinkers (i.e., participants that reported consuming at least seven alcohol-containing beverages per week) would be more sensitive to the reinforcing and positive subject-rated effects of d-amphetamine than light drinkers.
Data from four studies that employed similar d-amphetamine self-administration procedures and subject-rated drug-effect measures were included in the analysis. Light (n = 17) and moderate (n = 16) drinkers sampled placebo, low (8 to 10 mg), and high (16 to 20 mg) doses of oral d-amphetamine administered in eight capsules. Following sampling sessions, participants worked for a maximum of eight capsules, each containing 12.5% of the previously sampled dose, on a modified progressive-ratio schedule of reinforcement.
Both active doses of d-amphetamine functioned as a reinforcer in the moderate drinkers, while only the high dose did so in the light drinkers. The moderate drinkers worked for significantly more capsules that contained the high dose of d-amphetamine than did the light drinkers. d-Amphetamine produced prototypical stimulant-like subjective effects (e.g., dose-dependent increases in ratings of Good Effects; Like Drug and Willing to Take Again). Moderate drinkers reported significantly greater subjective effects than the light drinkers.
These results are consistent with those from previous laboratory experiments and suggest that moderate alcohol consumption may increase vulnerability to the abuse-related effects of stimulants.



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Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous’ Principal Theoretical Mechanism of Behavior Change



Evidence indicates Alcoholics Anonymous (AA) can play a valuable role in recovery from alcohol use disorder. While AA itself purports it aids recovery through “spiritual” practices and beliefs, this claim remains contentious and has been only rarely formally investigated. 

Using a lagged, mediational analysis, with a large, clinical sample of adults with alcohol use disorder, this study examined the relationships among AA, spirituality/religiousness, and alcohol use, and tested whether the observed relation between AA and better alcohol outcomes can be explained by spiritual changes.
Adults (N = 1,726) participating in a randomized controlled trial of psychosocial treatments for alcohol use disorder (Project MATCH) were assessed at treatment intake, and 3, 6, 9, 12, and 15 months on their AA attendance, spiritual/religious practices, and alcohol use outcomes using validated measures. General linear modeling (GLM) and controlled lagged mediational analyses were utilized to test for mediational effects.
Controlling for a variety of confounding variables, attending AA was associated with increases in spiritual practices, especially for those initially low on this measure at treatment intake. Results revealed AA was also consistently associated with better subsequent alcohol outcomes, which was partially mediated by increases in spirituality. This mediational effect was demonstrated across both outpatient and aftercare samples and both alcohol outcomes (proportion of abstinent days; drinks per drinking day).
Findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals’ spiritual practices and provides support for AA’s own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder.


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