An international website dedicated to providing current information on news, reports, publications,and peer-reviewed research articles concerning alcoholism and alcohol-related problems throughout the world. Postings are provided by international contributors who monitor news, publications and research findings in their country, geographical region or program area of interest. All postings are entered without editorial or contributor opinion or comment.
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.
Saturday, January 14, 2012
ICAP Announces Release of Guiding Principles for Responsible Beverage Alcohol Marketing
The International Center for Alcohol Policies (ICAP; www.icap.org) is pleased to announce the release of Guiding Principles for Responsible Beverage Alcohol Marketing associated with the Self-Regulation initiative of Global Actions on Harmful Drinking (www.global-actions.org).
“For the first time, we now have common global standards for alcohol marketing. This represents a major step in the long-standing commitment by the leading alcohol producers to effective self-regulation,” said World Federation of Advertisers Managing Director Stephan Loerke. “WFA looks forward to working with them to implement these standards at a local level.”
The Guiding Principles serve as a tool for highlighting the underlying global values in responsible advertising and marketing practices across beverage alcohol industry sectors and forming a basis for developing new codes or assessing existing codes in diverse markets.
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Global Actions: January 11, 2012
Key Recent Milestones:
· Vietnam: Evaluation site visits from Channel Research were conducted January 9 and 10 in Hanoi, and January 11 in Da Nang. For more on Global Actions’ evaluation process, click here.
Global Actions Spotlight: Vietnam Bus Driver Project Launch
Global Actions’ “Prevention and Control of Bus Drivers from Drink Driving at Bus Stations” project has successfully launched in two Vietnam provinces. The launch events, held in December 2011 in Dak Lak and Khanh Hoa provinces, coincide with an important new focus on traffic safety in Vietnam.
On January 3, all 63 Vietnam provinces participated in the launch of Traffic Safety Year 2012. The bus driver project was developed to support the Ministry of Transport’s (MOT) 2012 Traffic Safety Year Action Plan, a plan centered on four key areas of traffic safety: speeding, lane separation, drink driving, and helmets. According to Global Actions Country Manager Lan Huong Nguyen, traffic safety is now receiving more attention from government officials than ever before.
“The bus driver project has attracted considerable interest from Ministry of Transport (MOT) leaders,” said Nguyen. “When we met with the Traffic Safety Department on January 9, they said they would like us to expand the project to more bus stations and provinces in Vietnam.”
Vietnam’s Traffic Safety Department and Directorate for Roads of Vietnam (DRVN) have aided in our commitment to reduce the number of drink driving accidents in Vietnam. “The Ministry is using good practice from this project to revise the legal requirements against drink driving for bus drivers,” said Nguyen. “They are working to enhance regular and ongoing enforcement by transport inspectors.”
The bus driver project education and enforcement campaigns will run through January. “We are working with ICAP to design Phase 2 of the project,” said DRVN’s Deputy General Director Nguyen Van Quyen. “We think that all project activities can be sustained with ICAP’s continued supervision after the project ends in February 2012.”
What’s Happening Next:
· Colombia: Our team in Columbia is completing a best practices booklet "Experiencias Demostrativas" which focuses on the Pactos por la Vida program in six Colombian cities.
· China: Channel Research site visits will take place January 12-13 in Beijing, January 16-17 in Nanjing, and January 18 in Shanghai.
Friday, January 13, 2012
Placental Hypoxia and Foetal Development Versus Alcohol Exposure in Pregnancy
To examine the causes of variability in the effect of maternal drinking on the foetus, with particular reference to the pattern, frequency and duration of the period of drinking, differences in maternal, foetal and
placental metabolism of ethanol/acetaldehyde, and genetic factors.
Narrative review of published studies of the pathogenesis of foetal alcohol syndrome (FAS) with emphasis in the development of the central nervous system.
Animal models suggest that acetaldehyde, the primary hepatic oxidative metabolite of ethanol, reaches the foetus either by placental production or by placental transference, which in turn could affect foetal growth and development. The most likely hypothesis regarding the decrease of foetal growth is via hypoxia and increased oxidative/nitrative stress, which interfere with cellular processes that require oxygen in order to function adequately, such as placental transport.
There seems to be an association between the teratogenic effect, hypoxia and oxidative stress, the molecular mechanism involved (e.g. apoptosis) and the range of effects. The review sums ups the evidence that could explain some of the abnormalities in the brain development that could be related to behavioural problems observed in individuals with FAS/foetal alcohol spectrum disorder.
This suggests that alcohol consumption produces failures in the normal migration of radial cells, from which the rest of the brain cells would eventually develop.
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Thursday, January 12, 2012
Roles of the Locus Coeruleus and Adrenergic Receptors in Brain-Mediated Hypothalamic–Pituitary–Adrenal Axis Responses to Intracerebroventricular Alcoh
Alcohol activates the hypothalamic–pituitary–adrenal (HPA) axis through its actions in both the periphery and the central nervous system (CNS). The studies presented here were designed to test the CNS-specific noradrenergic mechanisms by which alcohol stimulates HPA activity in the male rat.
We used an experimental paradigm in which a small, nontoxic amount (5 μl) of alcohol was slowly microinfused intracerebroventricularly (icv). Alcohol was administered icv to animals with lesions of the locus coeruleus (LC) or in animals pretreated with α- or β-adrenergic receptor antagonists. Hormonal HPA activation was determined by measuring secretion of the pituitary stress hormone adrenocorticotropin (ACTH). Neuronal activation was determined by quantification of the expression of the transcription factor c-fos (Fos).
As expected, icv alcohol stimulated ACTH secretion from the pituitary and Fos expression in the paraventricular nucleus of the hypothalamus (PVN). Bilateral electrolytic LC lesions blocked the ability of icv alcohol to stimulate ACTH secretion. Pretreatment with icv propranolol increased basal ACTH secretion levels, but icv alcohol did not increase this effect. Propranolol also blunted icv alcohol-induced PVN Fos expression. A low dose of phenoxybenzamine, an α-adrenergic receptor antagonist, did not affect the ability of icv alcohol to stimulate ACTH release. However, a higher dose of the drug was able to block the ACTH response to icv alcohol. Despite this, phenoxybenzamine did not inhibit alcohol-induced Fos expression. Icv pretreatment with corynanthine, a selective α-1 adrenergic receptor antagonist, modestly raised basal ACTH levels and blocked the icv alcohol-induced secretion of this hormone.
These results indicate that the LC and norepinephrine play important roles in HPA activation caused by icv alcohol administration, but that the specific adrenergic receptor subtypes involved in this phenomenon still need to be identified.
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Responding in a Test of Decision-Making Under Risk is Under Moderate Genetic Control in the Rat
Risk-taking, measured with laboratory tasks such as the Balloon Analog Risk Task (BART), is associated with real-life manifestations of risky behaviors, which may be an important component of inherited liability to alcohol use disorders. To identify genomic factors that influence these traits, the current study (i) characterized performance of a rodent version of the BART in multiple inbred rat strains, (ii) tested the degree to which performance was under genetic control, (iii) explored sex differences in performance, and (iv) evaluated the risk-taking
behavior of F1 progeny of high-risk- and low-risk-taking strains to examine modes of inheritance.
Male and female rats (N = 100) from 5 inbred strains (Wistar-Furth, Fischer-344, Lewis, Spontaneously Hypertensive, Brown Norway) and Wistar-Furth × Fischer-344 hybrids were tested in the rat-BART, as well as in tests of locomotor activity, sucrose preference, and general motivation.
About 55% of the variance in risk-taking behavior was attributable to heritable factors. The Fischer-344 strain was the most risk-taking and the most variable in responding. The mating of low-risk-taking Wistar-Furth and Fischer-344 rats produced progeny that behaved most like the Fischer-344 strain. Consistent with prior research in this laboratory (Jentsch et al., 2010), all rats were sensitive to changes in both risk and reinforcement parameters in the rat-BART; rats decreased voluntary risk-taking in the face of increasing risk and increased lever pressing when reinforcement probabilities were reduced.
Our results endorse a moderately heritable pattern of risk-taking behavior in rats. The behavior of the hybrid progeny suggests a polygenic model with most gene effects transmitted by mode of dominant inheritance. The identification of high-risk and low-risk strains allows for isolation of quantitative trait loci associated with task performance and for probing the relationships between risk-taking and dimensions of alcohol use disorders.
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Heritability of Level of Response and Association with Recent Drinking History in Nonalcohol-Dependent Drinkers
Level of response (LR) to alcohol has been shown to be associated with the risk of developing alcohol dependence and can be measured using the self-rating of the effects of alcohol (SRE) questionnaire. This study examined the heritability of the SRE-measured LR and the relationship between LR and recent alcohol drinking history (RDH) in a predominantly African American nonalcohol-dependent population.
This was a sibling study of 101 social drinkers aged 21 to 35 years recruited from the Washington, DC metropolitan area. Participants were administered the SRE to assess LR and the timeline followback (TLFB) to assess RDH. The indices of SRE used were total SRE score (SRTT), early drinking SRE score (SRED), regular drinking SRE score (SRRD), and heavy drinking SRE score (SRHD). Pearson's product-moment correlation and linear regression were used to analyze SRE indices and RDH variables (quantity and drinks per drinking occasion). Heritability analysis was conducted using Sequential Oligogenic Linkage Analysis Routines (SOLAR) software with SRE indices as traits of interest.
There was a significant relationship between SRE and RDH measures. Drinks per drinking day, maximum drinks, and quantity of drinks were significantly associated with SRTT, SRHD, and SRRD (all p < 0.05). SRTT showed significant heritability (h2 = 0.67, p = 0.025), however, the SRE subindices (SRED, SRRD, SRHD) were not significantly heritable. Analysis performed in the subset consisting of only African Americans (n = 86) showed similar trends.
LR, as measured by the SRE, is associated with RDH. The high level of heritability of the SRE total score suggests that genetics accounts for a significant proportion of the variation in the LR to alcohol in social drinkers.
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The Interpretability of Family History Reports of Alcoholism in General Community Samples: Findings in a Midwestern U.S. Twin Birth Cohort
Although there is a long tradition in alcoholism research of using family history ratings, the interpretability of family history reports of alcoholism from general community samples has yet to be established.
Telephone interview data obtained from a large cohort of female like-sex twins (N = 3,787, median age 22) and their biological parents (N = 2,928, assessed at twins’ median age 15) were analyzed to determine agreement between parent self-report, parent ratings of coparent, and twin narrow (alcohol problems) and broad (problem or excessive drinking) ratings of each parent.
In European ancestry (EA) families, high tetrachoric correlations were observed between twin and cotwin ratings of parental alcohol problems, between twin and parent ratings of coparent alcohol problems using symptom-based and single-item assessments, as well as moderately high correlations between twin and both mother and father self-reports. In African American (AA) families, inter-rater agreement was substantially lower than for EA families, with no cases where father ratings of maternal alcohol problems agreed with either twin ratings or mother self-report, and both co-twin agreement and mother–twin agreement were reduced. Differences between EA and AA families were not explained by differences in years of cohabitation with father or mother's education; however, underreporting of problems by AA parents may have contributed.
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BBC Timeshift explores the social and cultural history of drinking in Britain
BBC Four's Timeshift, a documentary series into Britain's social and cultural history, featured episode 11 on 'The Rules of Drinking'. The episode is available for a further 5 days on BBC iplayer. > > > > Read More
Drinking patterns, psychological distress and quality of life in a Norwegian general population-based sample
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Multi-Level Analysis of Alcohol-Related Injury and Drinking Pattern: Emergency Department Data from 19 Countries
While drinking in the event is an important factor in injury occurrence, pattern of usual drinking may also be important in risk of injury. Explored here is the relationship of an alcohol-related injury with individual usual drinking pattern.
Alcohol-related injury is examined using Hierarchical Linear models, taking into account individual usual volume of consumption over the past 12 months, as well as aggregate-level detrimental drinking pattern (DDP) and alcohol policy measures.
Data analyzed are from emergency departments (EDs) in 19 countries, comprising three collaborative studies on alcohol and injury, all of which used a similar methodology.
The sample consists of 14,132 injured drinkers across 46 ER studies.
Alcohol-related injury was measured, separately, by any self-reported drinking prior to injury, a blood alcohol concentration (BAC) ≥.08, and self-reported causal attribution of injury to drinking.
While individual usual volume strongly predicted an alcohol-related injury for all three measures, usual drinking pattern also predicted an alcohol-related injury (controlling for volume), with episodic heavy and frequent heavy drinking both more predictive of alcohol-related injury than other drinking patterns. When individual usual volume and drinking pattern were controlled, DDP was no longer a significant predictor of alcohol-related injury. Alcohol policy measures were predictive of both BAC and causal attribution (the stronger the policy the lower the rates of alcohol-related injury)
Volume of alcohol typically consumed and occurrence of heavy drinking episodes are independently associated with incidence of alcohol-related injury. The stronger the anti-alcohol policies in a country, the lower the rates of alcohol-related injury.
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Health and economics experts clashed over the impact of introducing minimum unit pricing on alcohol, on Tuesday 10 January 2012.
The Health Committee was taking evidence on the Alcohol (Minimum Pricing) (Scotland) Bill at stage one of its scrutiny.
Benjamin Williamson from the Centre for Economics and Business Research told MSPs retailers stood to make windfall profits from minimum pricing "at the expense of poor consumers in Scotland."
However, Dr Evelyn Gillan from Alcohol Focus Scotland argued for minimum pricing saying "the people who stand to gain the most in this country are those on lowest incomes" because she said they stand to be the biggest health beneficiaries as "alcohol drives health inequalities".
Scottish Conservative MSP Jackson Carlaw questioned the panel over whether minimum pricing could have a negative effect on culture, with the resulting message that this was a "poor people's problem."
Dr Gillan disagreed with this assertion, maintaining instead minimum pricing was a "whole population measure."
Dr Peter Rice, Consultant Addictions Psychiatrist at NHS Tayside backed the bill and agreed minimum pricing would have "an impact on drinking right across all income groups" and, while other measures should be introduced in conjunction with the policy, it was ""a very important bit of the overall jigsaw."
He also commented on any proposed cost per unit saying it should be set "as high as can be without leading to considerable negative health consequences" such as home distilling and the setting of the price was "an ongoing process".
Professor Anne Ludbrook from the University of Aberdeen and Dr Jan S Gil from Queen Margaret University also added their support for minimum pricing.
Later, as can be viewed below, MSPs heard from Professor Timothy Stockwell from the University of Victoria who said introducing minimum pricing would be "courageous and brave":
Wednesday, January 11, 2012
Alcohol Consumption Induces Endogenous Opioid Release in the Human Orbitofrontal Cortex and Nucleus Accumbens
Excessive consumption of alcohol is among the leading causes of preventable death worldwide. Although ethanol modulates a variety of molecular targets, including several neurotransmitter receptors, the neural mechanisms that underlie its rewarding actions and lead to excessive consumption are unknown.
Studies in animals suggest that release of endogenous opioids by ethanol promotes further consumption.
To examine this issue in humans and to determine where in the brain endogenous opioids act to promote alcohol consumption, we measured displacement of a radiolabeled μ opioid receptor agonist, [11C]carfentanil, before and immediately after alcohol consumption in both heavy drinkers and control subjects.
Drinking alcohol induced opioid release in the nucleus accumbens and orbitofrontal cortex, areas of the brain implicated in reward valuation.
Opioid release in the orbitofrontal cortex and nucleus accumbens was significantly positively correlated. Furthermore, changes in orbitofrontal cortex binding correlated significantly with problem alcohol use and subjective high in heavy drinkers, suggesting that differences in endogenous opioid function in these regions contribute to excessive alcohol consumption.
These results also suggest a possible mechanism by which opioid antagonists such as naltrexone act to treat alcohol abuse.
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Overview of Alcohol Retail Policy
Research has shown that one of the most promising ways to reduce risky alcohol use, whether it involves adults or minors, is to control access. Simply put, the easier it is to get alcohol, the more likely it will be used or abused. The challenge is to find which specific mechanisms will best achieve the desired impact.
Given the range of problems associated with risky drinking - it is linked to an increased risk of car crashes, fights, rapes, murders, and property damage - a large body of public health research has emerged focusing on the potential of curbing alcohol-related problems by controlling the physical availability of alcohol. > > > > Read More
Moderate alcohol intake during pregnancy and risk of fetal death
Controversies still exist regarding the existence of a ‘safe’ level of alcohol intake during pregnancy. The aim of this study was to assess the risk of fetal death (spontaneous abortion and stillbirth) according to maternal alcohol consumption in a large Danish pregnancy cohort.
A cohort study carried out within the framework of the Danish National Birth Cohort. A total of the 92 719 participants enrolled in the Danish National Birth Cohort who provided information about lifestyle during first trimester of pregnancy were included in the study. Information about average weekly consumption of alcohol during pregnancy, smoking, coffee drinking, occupational status and reproductive history were obtained by means of computer-assisted telephone interviews. Pregnancy outcomes (spontaneous abortion, stillbirth, live birth and other pregnancy outcome) and gestational age at end of pregnancy were obtained through register linkage with the Civil Registration System and the National Discharge Registry. Data were analysed using Cox regression models, taking the varying gestational age at recruitment and time-dependent co-variables into account.
Fifty-five per cent of the participants abstained from alcohol drinking during pregnancy and only 2.2% reported four or more drinks per week. The adjusted hazard ratios for fetal death in first trimester were 1.66 [95% confidence interval (CI) 1.43–1.92] and 2.82 (95% CI 2.27–3.49) for women who reported 2–3½ drinks per week and 4 or more drinks per week, respectively, and 1.57 (95% CI 1.30–1.90) and 1.73 (95% CI 1.24–2.41) for fetal death during pregnancy weeks 13–16. No increased risk was found for fetal death after 16 weeks of pregnancy.
Even low amounts of alcohol consumption during early pregnancy increased the risk of spontaneous abortion substantially. The results indicate that the fetus is particularly susceptible to alcohol exposure early in pregnancy.
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Vital Signs: Binge Drinking Prevalence, Frequency, and Intensity Among Adults — United States, 2010
Morbidity and Mortality Weekly Report (MMWR) January 10, 2012 / 61(Early Release);1-7
Binge drinking accounts for more than half of the estimated 80,000 average annual deaths and three quarters of $223.5 billion in economic costs resulting from excessive alcohol consumption in the United States.
CDC analyzed data collected in 2010 on the prevalence of binge drinking (defined as four or more drinks for women and five or more drinks for men on an occasion during the past 30 days) among U.S. adults aged ≥18 years in 48 states and the District of Columbia; and on the frequency (average number of episodes per month) and intensity (average largest number of drinks consumed on occasion) among binge drinkers.
The overall prevalence of binge drinking was 17.1%. Among binge drinkers, the frequency of binge drinking was 4.4 episodes per month, and the intensity was 7.9 drinks on occasion. Binge drinking prevalence (28.2%) and intensity (9.3 drinks) were highest among persons aged 18–24 years. Frequency was highest among binge drinkers aged ≥65 years (5.5 episodes per month). Respondents with household incomes ≥$75,000 had the highest binge drinking prevalence (20.2%), but those with household incomes <$25,000 had the highest frequency (5.0 episodes per month) and intensity (8.5 drinks on occasion). The age-adjusted prevalence of binge drinking in states ranged from 10.9% to 25.6%, and the age-adjusted intensity ranged from 6.0 to 9.0 drinks on occasion.
Binge drinking is reported by one in six U.S. adults, and those who binge drink tend to do so frequently and with high intensity.
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An Overview of Alcohol Testing and Interpretation in the 21st Century
Ethanol analysis is the most commonly carried out drug testing in a forensic toxicology laboratory. Determination of blood alcohol concentration (BAC) is needed in a multitude of situations, including in postmortem analysis, driving under the influence (DUI) and drug-facilitated sexual assault (DFSA) cases, workplace drug monitoring, and probation investigations. These analyses are carried out by direct measurement of ethanol concentrations as well as of metabolic by-products, such as ethyl glucuronide (EtG) and ethyl sulfate (EtS).
This review article will discuss pharmacokinetics, including absorption, distribution, and elimination of ethanol, methods for the detection of ethanol, the effect of ethanol on human performance, the role of alcohol in injuries and fatalities, and information regarding the interactions that may occur between alcohol and other drugs.
Finally, an explanation will be given on how to interpret alcohol levels as well as the extrapolation and calculation of blood alcohol levels at times prior to sample collection.
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Tuesday, January 10, 2012
Larval Ethanol Exposure Alters Adult Circadian Free-Running Locomotor Activity Rhythm in Drosophila melanogaster
This study investigates developmental and behavioral correlates between larval ethanol exposure and the adult circadian clock in Drosophila melanogaster, a well-established model for studying circadian rhythms and effects of ethanol exposure.
We reared Drosophila larvae on 0%, 10%, or 20% ethanol-supplemented food and assessed effects upon eclosion and the free-running period of the circadian rhythm of locomotor activity.
We observed a dose-dependent effect of ethanol on period, with higher doses resulting in shorter periods. We also identified the third larval instar stage as a critical time for the developmental effects of 10% ethanol on circadian period.
These results demonstrate that developmental ethanol exposure causes sustainable shortening of the adult free-running period in Drosophila melanogaster, even after adult exposure to ethanol is terminated, and suggests that the third instar is a sensitive time for this effect.
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Dim Light Melatonin Onset in Alcohol-Dependent Men and Women Compared with Healthy Controls
Although the mechanisms of sleep disturbances of AD are not well understood and some evidence suggests dysregulation of circadian rhythms, dim light melatonin onset (DLMO) has not previously been assessed in AD versus healthy control (HC) individuals in a sample that varied by sex and race.
The authors assessed 52 AD participants (mean ± SD age: 36.0 ± 11.0 yrs of age, 10 women) who were 3–12 wks since their last drink (abstinence: 57.9 ± 19.3 d) and 19 age- and sex-matched HCs (34.4 ± 10.6 yrs, 5 women). Following a 23:00–06:00 h at-home sleep schedule for at least 5 d and screening/baseline nights in the sleep laboratory, participants underwent a 3-h extension of wakefulness (02:00 h bedtime) during which salivary melatonin samples were collected every 30 min beginning at 19:30 h. The time of DLMO was the primary measure of circadian physiology and was assessed with two commonly used methodologies.
There was a slower rate of rise and lower maximal amplitude of the melatonin rhythm in the AD group. DLMO varied by the method used to derive it. Using 3 pg/mL as threshold, no significant differences were found between the AD and HC groups. Using 2 standard deviations above the mean of the first three samples, the DLMO in AD occurred significantly later, 21:02 ± 00:41 h, than in HC, 20:44 ± 00:21 h (t = −2.4, p = .02).
Although melatonin in the AD group appears to have a slower rate of rise, using well-established criteria to assess the salivary DLMO did not reveal differences between AD and HC participants. Only when capturing melatonin when it is already rising was DLMO found to be significantly delayed by a mean 18 min in AD participants.
Future circadian analyses on alcoholics should account for these methodological caveats.
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Vital Signs: Binge Drinking
New estimates show that binge drinking is a bigger problem than previously thought. More than 38 million U.S. adults binge drink, about 4 times a month, and on average the largest number of drinks consumed is eight. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men over a short period of time.
As reported in this month’s Vital Signs, the CDC found that those who were thought less likely to binge drink actually engage in this behavior more often and consume more drinks when they do. While binge drinking is more common among young adults aged 18–34 years, binge drinkers aged 65 years and older report binge drinking more often—an average of five to six times a month. Similarly, while binge drinking is more common among those with household incomes of $75,000 or more, the largest number of drinks consumed on an occasion is significantly higher among binge drinkers with household incomes less than $25,000—an average of eight to nine drinks per occasion, far beyond the amount thought to induce intoxication.
Adult binge drinking is most common in the Midwest, New England, the District of Columbia, Alaska, and Hawaii. On average, however, the number of drinks consumed when binge drinking is highest in the Midwest and southern Mountain states (Arizona, Nevada, New Mexico, and Utah), and in some states— such as Louisiana, Mississippi, and South Carolina—where binge drinking was less common. > > > > Read More
The Case for Considering Quality of Life in Addiction Research and Clinical Practice
Substance use disorders are increasingly viewed as chronic conditions, and addiction treatment services are beginning to adopt models that were developed to address other chronic conditions.
These models address the impact of disease and services on the patient's overall well-being. From this perspective, treatment for addiction aims for the broad goal of recovery, which is defined as abstinence plus improved quality of life. However, the addiction field has come late to the chronic disease perspective, and the concept of quality of life in addiction is relatively undeveloped.
This article reviews the evidence for the relevance of quality of life in substance use disorder treatment and recovery and discusses the importance of incorporating quality-of-life indices into research and services.
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ONDCP Recovery Update Volume 1 No. 2 December 2011
A new quarterly publication from the White House Office of National Drug Control Policy's Recovery Branch.
- News from the Recovery Branch
- Research and Data
- Spotlight: Recovery in the Field
- Coming Up
Mapping Your Recovery Journey
This is a guide to help you think about what supports you will need to help you overcome your addiction to alcohol or drugs, and to help you towards a meaningful and fulfilling life.
This guide is to be used in conjunction with a ‘mentor’ who has already been down the road you are travelling and who will provide you with their support and expertise.
In our experience, it is this support – from the mentor (who we will call your RECOVERY CHAMPION) and from the other people who you already know or will meet in this journey that is most important. They will help you to build the strengths and skills you will need in what will sometimes be a rocky journey.
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Monday, January 9, 2012
Alcohol and sex: a cocktail for poor sexual health
The impact of rising alcohol consumption on population health has become increasingly evident in recent years, with steep increases in mortality and hospital admissions arising from chronic liver disease and alcohol-related accidents. Tackling alcohol misuse has become a national priority for both government and the wider public health community.
Excessive alcohol consumption has been linked with a range of adverse health outcomes.While apparent links between alcohol use and poor sexual health outcomes have been recognised for some time, the evidence for this link is now much more robust. Despite this, there has been little movement towards acknowledging and tackling this problem systematically and explicitly within sexual healthcare settings.
Young people are a key risk group: 16–24 year-olds are among the highest consumers of alcohol, in terms of both prevalence and unit consumption, and have the highest rate of sexually transmitted infections. Consumption of higher strength alcoholic drinks has increased, particularly among girls, and although men still consume more alcohol than women, young women are more likely to report feeling drunk. Earlier alcohol use is associated with early onset of sexual activity and is a marker of later sexual risk-taking, including lack of condom use, multiple sexual partners, sexually transmitted infection and teenage pregnancy. Sexual assault is strongly correlated with alcohol use by both victim and perpetrator. Responding to the problems of alcohol use among young people requires a multi-faceted approach. Restricting the availability of alcohol through pricing and strict enforcement of laws surrounding under-age drinking are particularly effective national policy options that can reduce alcohol use amongst young people. However, community-level and school-based interventions add an important component to a multi-dimensional strategy. > > > > Read Full Report
Social demography of alcohol-related harm to children in Australia
This study seeks to establish the prevalence alcohol-related harms to children (ARHC) that occur because of others’ drinking in the general population and examine how this varies by who was reported to have harmed the child and socio-demographic factors.
A randomly selected cross-sectional national population telephone survey undertaken in 2008 in Australia.
1,142 adult respondents who indicated they lived with or had a parental/carer role for children.
Questions included whether children had been negatively affected in any way, left unsupervised or in an unsafe situation, verbally abused, physically hurt or exposed to serious family violence because of others’ drinking in the past year.
22% of respondents reported children had been affected because of another's drinking in the past year; 3% reporting substantial harm. Respondents most commonly reported children were verbally abused because of others’ drinking (9%). Participants in single carer households were more likely to report ARHC than participants in households with two carers, and participants who drank weekly were more likely to report ARHC than those who did not drink.
Almost a quarter of those with a caring role for children in Australia reported that a child or children with whom they lived or were responsible for have been adversely affected by others' alcohol consumption in the past year. The problem extends across the social spectrum but children in single parent homes may be at higher risk.
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Involvement of nucleus accumbens dopamine D1 receptors in ethanol drinking, ethanol-induced conditioned place preference, and ethanol-induced psychomo
expression, of ethanol-induced place preference.
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Alcoholism-related alterations in spectrum, coherence, and phase synchrony of topical electroencephalogram
The objective of present work was to assess differences in spectrum, coherence, and phase synchrony of topical electroencephalogram (EEG) between alcohol-dependent individuals and healthy participants.
Surface currents were mitigated by a common average spatial filter. Parametric spectral and coherence estimates obtained for consecutive 0.5s-long EEG fragments were generally lower for alcoholics than for controls while evaluated for low EEG rhythms.
Phase synchrony computed for 2.34s-long overlapping EEG fragments was lower for alcoholics than for controls while evaluated in α(2) and β(1) rhythms and for specific electrode pairs.
Kruskal-Wallis one-way analysis of variance evaluated these alterations as statistically significant.
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Interactive Effects of Approach Motivational Intensity and Alcohol Cues on the Scope of Perceptual Attention
Many theoretical perspectives suggest that alcohol-related stimuli bear on attentional processes. Building upon these ideas and recent advances regarding the attention-constricting impact of approach motivational states, we predicted that mere exposure to alcohol-related images would suffice to reduce the breadth of attention among individuals who possessed a strong motivation to consume alcohol.
Two studies exposed participants to alcohol and neutral cues prior to assessing attention structure. In both studies, measures of alcohol use, negative alcohol expectancies, trait approach motivation, and alcohol-related approach motivation were assessed.
Study 1 comprised of 102 undergraduates and Study 2 comprised of 162 undergraduates. Studies were conducted at Texas A&M University, College Station, Texas.
In both studies, participants were briefly exposed to pictures of various stimuli (alcohol vs. neutral pictures). After each picture was displayed, participants completed a trial assessing attentional focus.
After controlling for relevant covariates, both studies demonstrated that exposure to alcohol-related pictures led to a narrowing of attentional focus among individuals who possessed a strong motivation to use alcohol. Exposure to neutral pictures, however, did not interact with alcohol-related motivation to influence attentional focus.
Alcohol cues narrow attentional breadth for individuals who are motivated to consume alcohol, suggesting a non-pharmacological means in which alcohol produces a narrow mindset. Alcohol cues may contribute to cognitive and behavioral deficits, as well as drinking behaviors, in part, because they lead to the inability to process a broad range of information in the environment.
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The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis
Most but not all epidemiological studies suggest a cardioprotective association for low to moderate average alcohol consumption. The objective was to quantify the dose-response relationship between average alcohol consumption and ischaemic heart disease (IHD) stratified by sex and IHD end point (mortality vs. morbidity).
A systematic search of published studies using electronic databases (1980-2010) identified 44 observational studies (case-control or cohort) reporting a relative risk measure for average alcohol intake in relation to IHD risk. Generalized least-squares trend models were used to derive the best-fitting dose-response curves in stratified continuous meta-analyses. Categorical meta-analyses were used to verify uncertainty for low to moderate levels of consumption in comparison to long-term abstainers.
The analyses used 38,627 IHD events (mortality or morbidity) among 957,684 participants. Differential risk curves were found by sex and end point. Although some form of a cardioprotective association was confirmed in all strata, substantial heterogeneity across studies remained unexplained and confidence intervals were relatively wide, in particular for average consumption of 1-2 drinks/day.
A cardioprotective association between alcohol use and ischaemic heart disease cannot be assumed for all drinkers, even at low levels of intake. More evidence on the overall benefit-risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low-risk drinking levels.
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A Latent Class Analysis of Alcohol Abuse and Dependence Symptoms Among Puerto Rican Youth
An NIDA-funded cross-sectional survey was administered to 622 middle and high school students in San Juan, Puerto Rico in 2000.
Latent class analysis (LCA) examined the Alcohol Abuse and Dependence symptoms. Three distinct classes of drinkers were found: low (86.0% of sample), moderate (11.7% of sample), and high (2.3% of sample) severity classes which were distinguished by differing estimated probabilities of symptom reporting.
The study has implications for the diagnosis of Alcohol Abuse and Dependence among Puerto Rican youths. Limitations are also noted.
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Alcohol News - 2/2012
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The effectiveness of an intervention in increasing community health clinician provision of preventive care: A study protocol of a non-randomised, mult
The primary behavioural risks for the most common causes of mortality and morbidity in developed countries are tobacco smoking, poor nutrition, risky alcohol use, and physical inactivity. Evidence, guidelines and policies support routine clinician delivery of care to prevent these risks within primary care settings. Despite the potential afforded by community health services for the delivery of such preventive care, the limited evidence available suggests it is provided at suboptimal levels. This study aims to assess the effectiveness of a multi-strategic practice change intervention in increasing clinician's routine provision of preventive care across a network of community health services.
A multiple baseline study will be conducted involving all 56 community health facilities in a single health district in New South Wales, Australia. The facilities will be allocated to one of three administratively-defined groups. A 12 month practice change intervention will be implemented in all facilities in each group to facilitate clinician risk assessment of eligible clients, and clinician provision of brief advice and referral to those identified as being 'at risk'. The intervention will be implemented in a non-random sequence across the three facility groups. Repeated, cross-sectional measurement of clinician provision of preventive care for four individual risks (smoking, poor nutrition, risky alcohol use, and physical inactivity) will occur continuously for all three facility groups for 54 months via telephone interviews. The interviews will be conducted with randomly selected clients who have visited a community health facility in the last two weeks. Data collection will commence 12 months prior to the implementation of the intervention in the first group, and continue for six months following the completion of the intervention in the last group. As a secondary source of data, telephone interviews will be undertaken prior to and following the intervention with randomly selected samples of clinicians from each facility group to assess the reported provision of preventive care, and the acceptability of the practice change intervention and implementation.
The study will provide novel evidence regarding the ability to increase clinician's routine provision of preventive care across a network of community health facilities.
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Examining Physical Activity Levels and Alcohol Consumption: Are People Who Drink More Active?
Summarize/categorize current scientific literature examining the association between alcohol consumption (AC) and levels of physical activity (PA).
Electronic databases spanning education, psychology, sociology, medicine, and interdisciplinary reports.
Included studies (n = 17) must be published in a peer-reviewed, English language journal; measure either AC or PA as an independent/dependent variable; and primarily examine the relationship between AC and PA.
Search terms/phrases included alcohol, alcohol consumption, drinking, physical activity, exercise, and physically active.
The Matrix Method and PRISMA guidelines organized pertinent literature and identified/extracted salient findings.
Alcohol consumers of all ages were more physically active than nondrinking peers. Further, several studies suggest a dose-response relationship between AC and PA, indicating that as drinking increases, so does PA level.
Reviewed studies support a positive association between AC and PA across all ages. Findings were contrary to the hypothesis of the investigators. Future research should place specific emphasis on identifying why alcohol consumers exercise at higher levels than non–alcohol consumers.
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Alcohol consumption and suicide rates in Russia
To estimate the aggregate level effect of alcohol on suicide rates in Russia.
Suicide is one of the main causes of premature mortality in Russia, bringing considerable losses of human lives. There is strong evidence of a crucial role of alcohol in the explanation of the high suicide rate and its profound fluctuations over the past decades in this country.
Trends in alcohol consumption per capita and suicide rates from 1980 to 2005 were analyzed employing autoregressive integrated moving
average (ARIMA) time series analysis.
The overall level of alcohol consumption was significantly associated with both male and female suicide rates. The estimates of the age specific models for men were positive and ranged from 0.029 (75+ age group) to 0.084 (30-44 age group). The estimates for women were positive for the age groups 15-29 (0.036), 30-44 (0.033), 45-59 (0.022) and 60-74 (0.008).
The outcome of this study provides indirect support for the hypothesis that alcohol played a crucial role in the fluctuation in suicide mortality rate in Russia during recent decades.
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