Environmental influences predominate in remission from alcohol use disorder in young adult twins

Familial influences on remission from alcohol use disorder (AUD) have been studied using family history of AUD rather than family history of remission. The current study used a remission phenotype in a twin sample to examine the relative contributions of genetic and environmental influences to remission.

The sample comprised 6183 twins with an average age of 30 years from the Australian Twin Registry. Lifetime history of alcohol abuse and dependence symptoms and symptom recency were assessed with a structured telephone interview. AUD was defined broadly and narrowly as history of two or more or three or more abuse or dependence symptoms. Remission was defined as absence of symptoms at time of interview among individuals with lifetime AUD. Standard bivariate genetic analyses were conducted to derive estimates of genetic and environmental influences on AUD and remission.

Environmental influences alone accounted for remission in males and for 89% of influences on remission in females, with 11% due to genetic influences shared with AUD, which decreased the likelihood of remission. For women, more than 80% of influences on remission were distinct from influences on AUD, and environmental influences were from individual experiences only. For men, just over 50% of influences on remission were distinct from those on AUD, and the influence of environments shared with the co-twin were substantial. The results for the broad and narrow phenotypes were similar.

The current study establishes young adult remission as a phenotype distinct from AUD and highlights the importance of environmental influences on remission.

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Request Reprint E-Mail: vmccutcheon@wustl.edu

Understanding Naltrexone Mechanism of Action and Pharmacogenetics in Asian Americans via Behavioral Economics: A Preliminary Study.

A behavioral economic approach to understanding the relative value of alcohol may be useful for advancing medication development for alcoholism. Naltrexone is a heavily researched and moderately effective treatment for alcohol dependence making it a good candidate for a proof-of-concept study of behavioral economics and alcoholism pharmacotherapy.

This study examines naltrexone efficacy and pharmacogenetics in terms of the relative value of alcohol, assessed via demand curve analysis.

Participants were 35 heavy drinking (AUDIT ≥8) Asian Americans. A within-subjects cross-over medication design was used along with an intravenous alcohol challenge completed after 4 days of both naltrexone and placebo. At baseline and BrAC = 0.06g/dl, participants completed an Alcohol Purchase Task, which assessed estimated alcohol consumption along escalating prices. Behavioral economic demand curve analysis yielded measures of intensity, elasticity, maximum expenditure (Omax), proportionate price insensitivity (Pmax) and breakpoint.

Compared to placebo, naltrexone significantly reduced intensity, Omax and breakpoint. There were also trend-level medication effects on Pmax. BrAC was associated with increases in Pmax and breakpoint. A significant naltrexone × OPRM1 genotype interaction was observed for intensity of demand.

The present study extends the literature on naltrexone's mechanisms through the application of a novel behavioral economic paradigm. These results indicate that naltrexone reduces several indices of demand for alcohol.

This preliminary report provides further evidence for the effectiveness of naltrexone and supports the utility of a behavioral economic approach to alcoholism pharmacotherapy development.



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Request Reprint E-Mail: lararay@psych.ucla.edu

Global Actions: March 21, 2012

Key Recent Milestones:

· Thailand: Our partner in Thailand, the Population and Community Development Association (PDA) recently traveled to selected villages in Thailand for the noncommercial alcohol initiative of Global Actions. In collaboration with the Thai Foundation for Responsible Drinking (TFRD), PDA staff interviewed village people and leaders about the impact of unrecorded alcohol on local communities.



Global Actions in Focus: Country Managers in Washington, D.C.

Global Actions country managers and ICAP regional coordinators convened in Washington, D.C. at the International Center for Alcohol Policies (ICAP) headquarters for a week-long collaboration to discuss Global Actions strategies. The week of March 12, coordinators participated in evaluation workshops with Channel Research, a communications workshop, and other meetings with ICAP staff and senior consultants.



The meeting marked the second gathering of all Global Actions country managers and regional coordinators to ICAP headquarters. ICAP president Marcus Grant launched the week with an overview of ICAP strategic review and plans for the future.



“We’re clear that ICAP’s goal is to be respected as the world’s leading think tank on alcohol. But our thinking only becomes relevant when it is translated into policies and programs,” said Grant. “The group gathered in Washington for this meeting represents the front line in testing how ICAP’s thinking works in the real world.”



The meeting included daily workshops by Channel Research. “The main purpose of the monitoring and evaluation workshop was to further enhance the linkages between planning, monitoring, and evaluation of the Global Actions initiatives by equipping the coordinators with a set of tools,” said Annina Mattsson.



“The group was enthusiastic and very receptive to the new tools provided,” Mattsson continued. “Channel Research will continue supporting the coordinators' monitoring and evaluation efforts in a coaching role throughout 2012.”



ICAP’s YouTube channel will soon be updated with interviews filmed during the week. Visit our Facebook page for event photos.



What’s Happening Next:

· Mexico: Global Actions Mexico is partnering with Aguas con el Alcohol to participate in a health fair hosted by Universidad de las Americas. The event will be held at the university in Puebla on March 22 and 23.

Ethanol up-regulates nucleus accumbens neuronal activity dependent pentraxin (Narp): implications for alcohol-induced behavioral plasticity

Neuronal activity dependent pentraxin (Narp) interacts with α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) glutamate receptors to facilitate excitatory synapse formation by aggregating them at established synapses. Alcohol is well-characterized to influence central glutamatergic transmission, including AMPA receptor function.

Herein, we examined the influence of injected and ingested alcohol upon Narp protein expression, as well as basal Narp expression in mouse lines selectively bred for high blood alcohol concentrations under limited access conditions.

Alcohol up-regulated accumbens Narp levels, concomitant with increases in levels of the GluR1 AMPA receptor subunit. However, accumbens Narp or GluR1 levels did not vary as a function of selectively bred genotype.

We next employed a Narp knock-out (KO) strategy to begin to understand the behavioral relevance of alcohol-induced changes in protein expression in several assays of alcohol reward.

Compared to wild-type mice, Narp KO animals: fail to escalate daily intake of high alcohol concentrations under free-access conditions; shift their preference away from high alcohol concentrations with repeated alcohol experience; exhibit a conditioned place-aversion in response to the repeated pairing of 3 g/kg alcohol with a distinct environment and fail to exhibit alcohol-induced locomotor hyperactivity following repeated alcohol treatment.

Narp deletion did not influence the daily intake of either food or water, nor did it alter any aspect of spontaneous or alcohol-induced motor activity, including the development of tolerance to its motor-impairing effects with repeated treatment.

Taken together, these data indicate that Narp induction, and presumably subsequent aggregation of AMPA receptors, may be important for neuroplasticity within limbic subcircuits mediating or maintaining the rewarding properties of alcohol.


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Request Reprint E-Mail: szumlinski@psych.ucsb.edu

Ontogenetic differences in ethanol's motivational properties during infancy

Pairing a conditioned stimulus (CS) with ethanol generally produces aversion for that CS in adult rodents. However, infant rats (PD1-PD3) exposed to ethanol demonstrate appetitive reinforcement to ethanol (Nizhnikov, Varlinskaya, Petrov, & Spear, 2006; Petrov, Varlinskaya, & Spear, 2003). This sensitivity to the appetitive properties of ethanol during infancy may be transient, as during the second postnatal week rat pups tend to exhibit conditioned aversions to flavors paired with ethanol.

The present study examined changes in the motivation properties of ethanol through ontogeny and the neurobiology underlying these changes. Rat pups were exposed to a taste conditioning procedure on PD4 or PD12. Rat pups were intraorally infused with 2.5% of their body weight of saccharin solution (0.1%) and immediately after injected intraperitoneolly (i.p.) with one of six doses of ethanol (0.0–2.0 g/kg). A day later pups were given saccharine infusions and percent body weight gain was used as an index of ethanol's reinforcing effects.

PD4 pups expressed appetitive reinforcement to ethanol, as indicated by greater saccharin intake, as compared to control counterparts and to the older PD12 pups. Subsequent experiments revealed that PD4 pups were less sensitive to the aversive properties of the drug than PD12 pups. The older pups found high doses of ethanol aversive while PD4 rat pups did not condition aversions to this dose of ethanol after a single trial.

A similar pattern of results was observed between the low doses of ethanol and the highest doses of a kappa opioid agonist. The PD12 animals did not condition to the kappa opioid agonist, while the younger rats expressed an appetitive response.

These results illustrate an ontogenetic change in the motivational properties of ethanol, with sensitivity to its appetitive properties declining and responsiveness to the aversive properties increasing with age during early infancy.


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Recognized spontaneous abortion in mid-pregnancy and patterns of pregnancy alcohol use

Alcohol consumption during pregnancy is one potential risk factor for spontaneous abortion (SAb). Prior research suggested that heavy drinking during pregnancy was associated with significantly increased rates of SAb, but results for lower levels of drinking have been inconsistent.

We examined the association between different levels and patterns of prenatal alcohol consumption and SAb in a high-risk inner-city sample. We hypothesized that higher levels, binge patterns, and more frequent drinking would be associated with increased rates of SAb.

The quantity and frequency of self-reported peri-conceptional and repeated in-pregnancy maternal drinking volumes per beverage type were assessed with semi-structured interviews in a prospective subsample of 302 African-American mothers. Relations between various measures of prenatal alcohol exposure and SAb were assessed using logistic regression.

After controlling for various potential confounders, there was a significant positive relation between average absolute alcohol use per day across pregnancy and SAb. Greater frequency of drinking episodes also predicted SAb: an average of even one day of drinking per week across pregnancy was associated with an increase in the incidence of SAb. However, contrary to our hypothesis, neither the amount of alcohol drunk per drinking day nor a measure of binge drinking was significantly related to SAb after controlling for confounders.

Differences in when women who drank at risk levels initiated antenatal care may have under-estimated the impact of alcohol on SAb in this low-SES urban African-American sample. Some drinking measures averaged across pregnancy may have under-estimated consumption and overestimated risk of SAb, but other risk drinking measures that avoid this limitation show similar relations to SAb.

Identifying fetal risk drinking in pregnant women is critical to increasing the effectiveness of interventions that reduce risk level alcohol consumption and protect from pregnancy loss.


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Request Reprint E-Mail: lchiodo@med.wayne.edu

Effect of l-cysteine on acetaldehyde self-administration

Acetaldehyde (ACD), the first metabolite of ethanol, has been implicated in several behavioural actions of alcohol, including its reinforcing effects. Recently, we reported that l-cysteine, a sequestrating agent of ACD, reduced oral ethanol self-administration and that ACD was orally self-administered.

This study examined the effects of l-cysteine pre-treatment during the acquisition and maintenance phases of ACD (0.2%) self-administration as well as on the deprivation effect after ACD extinction and on a progressive ratio (PR) schedule of reinforcement. In a separate PR schedule of reinforcement, the effect of l-cysteine was assessed on the break-point produced by ethanol (10%). Furthermore, we tested the effect of l-cysteine on saccharin (0.2%) reinforcement. Wistar rats were trained to self-administer ACD by nose poking on a fixed ratio (FR1) schedule in 30-min daily sessions.

Responses on an active nose-poke caused delivery of ACD solution, whereas responses on an inactive nose-poke had no consequences. l-cysteine reduced the acquisition (40 mg/kg), the maintenance and the deprivation effect (100 mg/kg) of ACD self-administration. Furthermore, at the same dose, l-cysteine (120 mg/kg) decreased both ACD and ethanol break point. In addition, l-cysteine was unable to suppress the different responses for saccharin, suggesting that its effect did not relate to an unspecific decrease in a general motivational state. Compared to saline, l-cysteine did not modify responses on inactive nose-pokes, suggesting an absence of a non-specific behavioural activation.

Taken together, these results could support the hypotheses that ACD possesses reinforcing properties and l-cysteine reduces motivation to self-administer ACD.


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Alcohol Consumption, Genetic Variants in Alcohol Deydrogenases, and Risk of Cardiovascular Diseases: A Prospective Study and Meta-Analysis

First, to investigate and compare associations between alcohol consumption and variants in alcohol dehydrogenase (ADH) genes with incidence of cardiovascular diseases (CVD) in a large German cohort. Second, to quantitatively summarize available evidence of prospective studies on polymorphisms in ADH1B and ADH1C and CVD-risk.

We conducted a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a randomly drawn subcohort (n = 2175) and incident cases of myocardial infarction (MI; n = 230) or stroke (n = 208). Mean follow-up time was 8.2±2.2 years. The association between alcohol consumption, ADH1B or ADH1C genotypes, and CVD-risk was assessed using Cox proportional hazards regression. Additionally, we report results on associations of variants in ADH1B and ADH1C with ischemic heart disease and stroke in the context of a meta-analysis of previously published prospective studies published up to November 2011.

Compared to individuals who drank >0 to 6 g alcohol/d, we observed a reduced risk of MI among females consuming >12 g alcohol/d (HR = 0.31; 95% CI: 0.10–0.97) and among males consuming >24 to 60 g/d (HR = 0.57; 95% CI: 0.33–0.98) or >60 g alcohol/d (HR = 0.30; 95% CI: 0.12–0.78). Stroke risk was not significantly related to alcohol consumption >6 g/d, but we observed an increased risk of stroke in men reporting no alcohol consumption. Individuals with the slow-coding ADH1B*1/1 genotype reported higher median alcohol consumption. Yet, polymorphisms in ADH1B or ADH1C were not significantly associated with risk of CVD in our data and after pooling results of eligible prospective studies [ADH1B*1/1: RR = 1.35 (95% CI: 0.98–1.88; p for heterogeneity: 0.364); ADH1C*2/2: RR = 1.07 (95% CI: 0.90–1.27; p for heterogeneity: 0.098)].\

The well described association between alcohol consumption and CVD-risk is not reflected by ADH polymorphisms, which modify the rate of ethanol oxidation.

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Co-variations and Clustering of Chronic Disease Behavioral Risk Factors in China: China Chronic Disease and Risk Factor Surveillance, 2007

Chronic diseases have become the leading causes of mortality in China and related behavioral risk factors (BRFs) changed dramatically in past decades. We aimed to examine the prevalence, co-variations, clustering and the independent correlates of five BRFs at the national level.

We used data from the 2007 China Chronic Disease and Risk Factor Surveillance, in which
multistage clustering sampling was adopted to collect a nationally representative sample of 49,247 Chinese aged 15 to 69 years. We estimated the prevalence and clustering (mean number of BRFs) of five BRFs: tobacco use, excessive alcohol drinking, insufficient intake of vegetable and fruit, physical inactivity, and overweight or obesity. We conducted binary
logistic regression models to examine the co-variations among five BRFs with adjustment of demographic and socioeconomic factors, chronic conditions and other BRFs. Ordinal logistic regression was constructed to investigate the
independent associations between each covariate and the clustering of BRFs within individuals. Overall, 57.0% of Chinese population had at least two BRFs and the mean number of BRFs is 1.80 (95% confidence interval: 1.78–1.83). Eight of the ten pairs of bivariate associations between the five BRFs were found statistically significant. Chinese with older age, being male, living in rural areas, having lower education level and lower yearly household income experienced increased
likelihood of having more BRFs.

Current BRFs place the majority of Chinese aged 15 to 69 years at risk for the future development
of chronic disease, which calls for urgent public health programs to reduce these risk factors. Prominent correlationsbetween BRFs imply that a combined package of interventions targeting multiple BRFs might be appropriate.


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Press Release - Alcohol industry sheds a billion units to cut hospital admissions and 1,000 deaths

A billion units of alcohol will be shed by the alcohol industry through an ambitious plan to help customers drink within guidelines, Health Secretary Andrew Lansley announced today.

The initiative, which is part of the Responsibility Deal, is being spearheaded by 34 leading companies behind brands like Echo Falls, First Cape and Heineken and will see a greater choice of lower strength alcohol products and smaller measures by 2015.

Market intelligence suggests consumers are increasingly looking for lower strength wines. In the past year, demand for lower and non-alcoholic beer has soared by 40 per cent across all retailers.

Key commitments include new and lighter products, innovating through existing brands and removing products from sale. They include:

• Sainsbury’s have pledged to double the sales of lighter alcohol wine and reduce the average alcohol content of own brand wine and beer by 2020.

• 25 million units will be gradually removed from Accolade Wines including Echo Falls Rosé and Echo Falls White Zinfandel;

• Brand Phoenix – have committed to taking 50 million units of alcohol out of their wines – by reducing 0.8 per cent ABV on all FirstCape full strength red wines;

• Molson Coors, the UK’s largest brewer, has committed to remove 50 million units by December 2015;

• 100 million units will be removed by Heineken;

• own brand super-strength lager will be removed from sale by wholesaler Makro;

• Tesco, the leading retailer for low alcohol drinks, will reduce the alcohol content of its own-label beer and cider and expand its range of lower alcohol wines and beers, already the biggest selling range in the UK.

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Substance Abuse and Addiction Collections

Learn more about the Substance Abuse and Addiction project here .

Learn more about the resulting Substance Abuse and Addiction Collections here.

To view the Substance Abuse and Addiction Working Group rosters, click here: WG #1 , WG #2 , WG #3 .

Collections
Substance Abuse and Addiction

Core Collection

Core: Tier 1

Core: Tier 2

Assessment of Substance Use and Substance Use Disorders »

Substance Use-related Co-morbidities and Health-related Outcomes »

Substance Use-related Community Factors »

Substance Use-related Neurobehavioral and Cognitive Risk Factors »

Substance Use-related Psychosocial Risk Factors »

Substance-specific Intermediate Phenotypes »

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National alcohol strategy 2012: 'Choice, Challenge and Responsibility' confirms minimum pricing for England

The rumours were true; the new Government Alcohol Strategy: Choice, Challenge and Responsibility confirms minimum pricing is to be brought in for England. Although the unit price is still to be set, in a press release the Prime Minister said "if it is 40p that could mean 50,000 fewer crimes each year and 9,000 fewer alcohol related deaths over the next decade."

The strategy sets out key policies including:

• a minimum unit price for alcohol;
• banning the sale of multi-buy discount deals;
• zero tolerance of drunken behaviour in A&E departments;
• a late night levy to get pubs and clubs helping to pay for policing; and
• improved powers to stop serving alcohol to drunks.

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Neonatal screening for prenatal alcohol exposure: Assessment of voluntary maternal participation in an open meconium screening program

Meconium fatty acid ethyl esters (FAEEs) are validated biomarkers of fetal alcohol exposure. Meconium FAEE testing can potentially be used as a screen by health-care professionals to identify neonates at-risk for Fetal Alcohol Spectrum Disorder, thereby permitting diagnostic follow-up of these children and early intervention in those who develop disabilities.

The purpose of this study was to assess whether women would willingly partake in a screening program of this nature. This was determined by launching a pilot screening program for prenatal alcohol exposure in a high-risk obstetric unit previously shown to have a high prevalence of FAEE-positive meconium via anonymous meconium testing.

The program involved voluntary testing of meconium for FAEEs and long-term developmental follow-up of positive cases through an existing public health program

The participation rate in the screening program was significantly lower than when testing was conducted anonymously (78% vs. 95%, respectively; p < 0.05), and the positivity rate was 3% in contrast to 30% observed under anonymous conditions (p < 0.001).

These low rates suggest that the majority of mothers who consumed alcohol in pregnancy refused to participate.

We conclude that despite the potential benefits of such screening programs, maternal unwillingness to consent, likely due to fear, embarrassment, and guilt, may limit the effectiveness of meconium testing for population-based open screening, highlighting the need for public education and social marketing efforts for such programs to be of
benefit.



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Request Reprint E-Mail: gkoren@sickkids.ca

Influence of chronic ethanol intake on mouse synaptosomal aspartyl aminopeptidase and aminopeptidase A: Relationship with oxidative stress indicators

Aminopeptidase A (APA) and aspartyl aminopeptidase (ASAP) not only act as neuromodulators in the regional brain renin-angiotensin system, but also release N-terminal acidic amino acids (glutamate and aspartate). The hyperexcitability of amino acid neurotransmitters is responsible for several neurodegenerative processes affecting the central nervous system.

The purpose of the present work was to study the influence of chronic ethanol intake, a well known neurotoxic compound, on APA and ASAP activity under resting and K⁺-stimulated conditions at the synapse level.

APA and ASAP activity were determined against glutamate- and aspartate-β-naphthylamide respectively in mouse frontal cortex synaptosomes and in their incubation supernatant in a Ca²⁺-containing or Ca²⁺-free artificial cerebrospinal fluid. The neurotoxic effects were analyzed by determining free radical generation, peroxidation of membrane lipids and the oxidation of synaptosomal proteins. In addition, the bioenergetic behavior of synaptosomes was analyzed under different experimental protocols.

We obtained several modifications in oxidative stress parameters and a preferential inhibitor effect of chronic ethanol intake on APA and ASAP activities. Although previous in vitro studies failed to show signs of neurodegeneration, these in vivo modifications in oxidative stress parameters do not seem to be related to changes in APA and ASAP, invalidating the idea that an excess of free acidic amino acids released by APA and ASAP induces neurodegeneration.



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Request Reprint E-Mail: mdmayas@ujaen.es

Folate exacerbates the effects of ethanol on peripubertal mouse mammary gland development

Alcohol consumption is linked with increased breast cancer risk in women, even at low levels of ingestion. The proposed mechanisms whereby ethanol exerts its effects include decreased folate levels resulting in diminished DNA synthesis and repair, and/or acetaldehyde-generated DNA damage.

Based on these proposed mechanisms, we hypothesized that ethanol would have increased deleterious effects during periods of rapid mammary gland epithelial proliferation, such as peripuberty, and that folate deficiency alone might mimic and/or exacerbate the effects of ethanol.

To test this hypothesis, weight-matched 28–35 day old CD2F1 female mice were pair-fed liquid diets ±3.2% ethanol, ±0.1% folate for 4 weeks. Folate status was confirmed by assay of liver and kidney tissues.

In folate deficient mice, no significant ethanol-induced changes to the mammary gland were observed. Folate replete mice fed ethanol had an increased number of ducts per section, due to an increased number of terminal short branches. Serum estrogen levels were increased by ethanol, but only in folate replete mice.

These results demonstrate that folate deficiency alone does not mimic the effects of ethanol, and that folate deficiency in the presence of ethanol blocks proliferative effects of ethanol on the mammary ductal tree.



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Request Reprint E-Mail: pmwelch@buffalo.edu

Drinking refusal self-efficacy and tension-reduction alcohol expectancies moderating the relationship between generalized anxiety and drinking behavio

Despite the substantial comorbidity between generalized anxiety disorder (GAD) and alcohol use disorders (AUD), little is known about contributing factors to this relationship. This lack of knowledge has limited the development of theoretical models explicating the interesting yet complex relationship between GAD and AUD.

The current study examined the roles of generalized anxiety, tension-reduction alcohol expectancies, and drinking refusal self-efficacy in accounting for the variance of alcohol consumption and alcohol-related consequences in a sample of young adult drinkers (N = 474; 18–25 years of age, median age 19, 66% female) from a large, urban Midwestern university.

Results showed that generalized anxiety level interacted with both tension-reduction alcohol expectancies and drinking refusal self-efficacy to predict alcohol consumption and alcohol-related consequences.

Findings support the assessment of both alcohol-related consequences and alcohol consumption, and highlight the importance of drinking refusal self-efficacy, which is a currently underexamined variable.

Study results also enhance the knowledge about the underlining mechanisms of GAD and AUD comorbidity, which facilitates the development of an empirically based theoretical paradigm for their relationship.



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Request Reprint E-Mail: giao.tran@uc.edu

The College Drinker’s Check-Up: Outcomes of two randomized clinical trials of a computer-delivered intervention.

The objective of the study was to evaluate the effectiveness of a computer-delivered intervention (CDI) to reduce heavy drinking and alcohol-related problems in college students in two randomized clinical trials.

In Experiment 1, we randomized 144 students to either the CDI or an assessment-only control group with follow-ups at 1 and 12 months. In Experiment 2, we randomized 82 students to either the CDI or a delayed-assessment control group with follow-up at 1 month.

In Experiment 1, participants in both groups significantly reduced their drinking at both follow-ups. Compared to the control group, the CDI group reduced their drinking significantly more at 1 and 12 months on three drinking measures at α < .05.

Using a more conservative, Bonferroni-adjusted criterion yielded one significant difference in a measure of heavier drinking at the 1 month follow-up. The mean between-groups effect sizes were d = .34 and .36 at 1 and 12 months, respectively. Experiment 2.

Compared to the delayed assessment control group, the CDI group significantly reduced (by the Bonferroni-adjusted criterion) their drinking on all consumption measures.

These results support the effectiveness of the CDI with heavy drinking college students when used in a clinical setting. In addition, the significant reductions in typical drinking in the control group in Experiment 1 and not in Experiment 2 combined with comparable baseline characteristics suggests that the control group in Experiment 1 demonstrated assessment reactivity.



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Request Reprint E-Mail: reidhester@behaviortherapy.com

Sexual orientation and substance abuse treatment utilization in the United States: Results from a national survey

This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, and behavior) in a large national sample of adults in the United States.

Prevalence estimates were based on data collected from the 2004–2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults 20 years and older, and represented a population that was 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. An estimated 2% of the target population self-identified as lesbian, gay or bisexual; 4% reported same-sex sexual behavior, and 6% reported same-sex sexual attraction.

Sexual minorities, especially women, had a greater likelihood of lifetime substance use disorders and earlier age of drinking onset. The majority of respondents with substance use disorders were untreated and lifetime substance abuse treatment utilization differed based on sexual orientation. Sexual minorities were found to have more extensive family histories of substance abuse problems.

The findings indicate the underutilization of substance abuse treatment among all adults, and highlight some important factors to consider when working with sexual minorities.



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Request Reprint E-Mail: plius@umich.edu

Press Release - Middle School Teacher Support Lowers Risk for Early Alcohol Use

Anxiety, depression, stress and social support can predict early alcohol and illicit drug use in youth, according to a study from Carolyn McCarty, PhD, of Seattle Children’s Research Institute, and researchers from the University of Washington and Seattle University. Middle school students from the sixth to the eighth grade who felt more emotional support from teachers reported a delay in alcohol and other illicit substance initiation. Those who reported higher levels of separation anxiety from their parents were also at decreased risk for early alcohol use. The study, “Emotional Health Predictors of Substance Use Initiation During Middle School,” was published in advance online in Psychology of Addictive Behaviors.
> > > > Read More

Emotional health predictors of substance use initiation during middle school.

This study aimed to evaluate whether emotional health factors, including anxiety and depression, stress, and social support, are associated with earlier youth initiation of alcohol and illicit substances during middle school (from the sixth to the eighth grade).

Data for this study were from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Discrete time survival analyses were used to assess the effects of depression, anxiety, stress, and support on initiation of substance use, measured every 6 months at five time points between sixth and eighth grade.

Youth who had initiated prior to sixth grade had significantly higher levels of depressive symptoms. In multivariate survival analyses controlling for child race/ethnicity, gender, and socioeconomic status, and accounting for conduct problems, youth who reported higher levels of separation anxiety/panic symptoms were at decreased risk for early alcohol initiation. Children with higher levels of perceived teacher support had a significantly lower risk of alcohol initiation during early follow-up periods. Recent stressful life events in Grade 6 were associated with significantly greater risk of initiating an illicit substance by Grade 8.

The current findings highlight the role of stress in the initiation of illicit substance use and suggest that teacher support is associated with lower risk for very early alcohol use. Future research examining anxiety as a predictor of substance use should distinguish between subtypes of anxiety.


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

Recovery Community Center Survey

Faces & Voices asks for your help in carrying out the first-ever survey of Recovery Community Centers across the country. A growing number of Recovery Community Centers are providing opportunities for recovery support, civic engagement, leadership development and for the recovery community to engage with the greater community as a key stakeholder.

The majority of Recovery Community Centers are operated by recovery community organizations, often with paid staff that train and manage a vast network of volunteers. With your help, we would like to find out more about them so that we can inform recovery advocates around the country about their evolution and development. With your help, we will compile and distribute a comprehensive informational resource on Recovery Community Centers.

Please fill out our on-line survey by Friday, March 30, 2012.

News & updates March 2012

Budget 2012 - alcohol duty escalator continues

Scotland's minimum pricing steps forward

Other news

> > > > Read More

Nordic alcohol statistics 2003-2010

The Nordic alcohol statistics are produced
annually by the Nordic statistics authorities
and represent standardized data on alcohol
sales, distribution, prices and some
alcohol related harm.


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Beer, wine and distilled spirits in Ontario: A comparison of recent policies, regulations and practices

There is a long-standing discussion about whether some beverages are more likely to be linked with high-risk drinking and damage than others, and implications for beverage specific alcohol policies. While the evidence is inconclusive, when controlling for individual consumption, some studies have shown elevated risks by beverage type. This paper examines the situation in Ontario, Canada, from 1995 to present (2011) on several dimensions in order to assess
the differences by beverage and their rationale with a specific focus on the most recent policie.

This paper draws on archival consumption statistics, taxation and pricing arrangements, and retailing and marketing practices.

Off-premise sales, which represent an estimated 75% of ethanol, involve several channels: stores controlled by the Liquor Control Board (LCBO)-which sell all spirits, imported and domestic wines, and beer products; the Beer Store network which sell all beers; and Ontario winery stores-which sell Ontario wines. In LCBO stores Ontario wines are more prominently displayed than other beverages, and extensive print advertising tends to feature wine over beer and spirits. There are also differences by beverage in terms of taxation and price. The taxes on higher alcohol content beverage types account for a higher portion of the retail price than taxes on lower alcohol content beverage types. Furthermore, minimum price regulations allow for differential minimum pricing per standard drink [17.05 ml ethanol] across beverage types.

The apparent rationale for these arrangements is not primarily that of favouring lighter-strength beverages in order to reduce harm, but rather to accommodate long-standing vested interests which are primarily financially based.


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In fear of a reversal back to the spirits-drinking era-the 2004 decrease of Finnish alcohol taxes in public discourse

The study investigates how the dissimilar tax reductions for different alcoholic beverages (spirits, wine and beer) were debated during the large tax decrease on alcoholic beverages in Finland in 2004.

The material comprises parliamentary proceedings and discussions, as well as daily press items (=105) from 2003-2004. Content analyses, both quantitative and qualitative, were performed.

The parliament's discussion on the unequal treatment of different beverage types concerned mostly the overall framing of a public health perspective, differencing between consumption of "spirits" and "non-spirits". The mass media framed the question mostly from the industry's point of view. Neither a clear support of the total consumption model (excluding specification of beverage sort), nor a strong liberalisation model for alcohol policy were expressed in the materials. Varying stances were merely motivated within a paradigm of "changing drinking patterns".

The differing treatment of different beverage types, especially the large reductions in spirits taxes, was crystallised as the fundamental public health concern surrounding the decision to lower alcohol taxes. In the end of the article the authors ask whether the lack of clear stances other than the drinking pattern framing could imply that the Finnish alcohol policy debate has become more heterogeneous, neutralised or resigned in its basic nature.


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The effects of favouring lower alcohol content beverages: Four examples from Finland

This paper studies the possibility of substituting the consumption of one alcoholic beverage category for another by changing alcohol control measures. It examines four Finnish examples: the waiving in 1952 of the requirement to show a special identity card issued by the alcohol monopoly Alko for buying fortified wines; again binding the sales of fortified wines to Alko's identity card in 1958; a 1960s alcohol price policy favouring wines and beer over vodka; and the change in alcohol legislation in 1968, which allowed selling medium beer in grocery stores but left the off-premise sales of all stronger alcoholic beverages to Alko's liquor stores.

Data on recorded consumption of alcoholic beverages in terms of 100 per cent alcohol per capita according to beverage categories will be used together with the numbers of arrests for drunkenness according to beverage categories as well as different data sources on changes in alcohol control measures.

The four examples from Finland show that strong alcoholic beverages can be substituted for lighter drinks, but this seems to work especially when the lighter beverages can be used for the same purposes as the stronger ones. It is much more difficult to persuade consumers to substitute strong alcoholic beverages for light ones by changing relative alcohol availability or by adjusting prices, if the consumers also have to change their drinking habits by, for instance, substituting binging with vodka for drinking light wines with meals. The Finnish examples also make it clear that changing from one beverage category to another does not automatically result in changing the way to use alcoholic beverages or the drinking habits themselves.


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The controversial discourse on beer in Iceland

This study investigates the motives and discourses around the decision taken by the Icelandic parliament in 1989 to legalise beer sales after a prohibition of 74 years. A bill was passed in 1988 that allowed the selling of beer in licensed restaurants and the state alcohol monopoly stores.

The sources used for this study are mainly newspaper articles and other materials and reports published in the period 1980 to 1989.

The passing of the bill was preceded by many controversial discourses in Iceland. Lobbying groups with commercial interests campaigned for the legalisation of beer, while representatives of the alcoholism movement took no formal stance on the issue, parliamentarians broke from party lines and medical doctors were split into two factions. Common questions included the plausibility of the total consumption model, various understandings of WHO recommendations, diverging interpretations of other countries' experiences of beer, and different views on how beer would affect individuals suffering from alcoholism.

The changes in Icelandic alcohol policy to legalise beer were in keeping with contemporary societal processes of globalisation and modernisation, but public health arguments were given less priority. While the decision to legalise beer increased the commercial functions of the state alcohol monopoly, it also strengthened the monopoly's role as an actor in alcohol policy.


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Does Norwegian alcohol policy favour lower alcohol content beverages? A historical overview

A historical overview of the relation between Norwegian alcohol policy and problems caused by different alcoholic beverages during the last two centuries.

The main thesis is that the concrete shaping of Norwegian alcohol policy changes according to the beverage which is supposed to cause most harm. Traditionally, this beverage has been liquor, and the Norwegian alcohol policy has mainly been occupied with the evils of spirits. Problems following from the consumption of beer and wine have been seen as relatively modest. At times, these weaker beverages have been viewed as a temperate alternative to the stronger spirits. After WWII, the government chose a policy which tended to favour wine over liquor and beer. Wine consumption was related to a somewhat more sophisticated and cultural sphere than the rude consumption of beer and spirits.


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Beer-an antidote or a stepping stone to liquor? Conceptions of different beverage types in alcohol policy

This thematic issue of NAD tackles the dissimilar treatment of different alcohol beverages in alcohol policy making. It stems from a project that came about when a group of researchers started to reflect on the conscious steering of consumption towards specific beverage types (with low alcohol-content). The main impetus was the meeting in Moscow in 2007 on ”Developing Effective Alcohol Policy for Russia: World Experience and Russian Realities”. Nordic researchers were invited by the Russian organisers, who had found that all Nordic countries during the 20th century had moved away from ”spiritsdrinking cultures”. In 2007, shifting from vodka to beer was seen as a possible solution to Russia’s drinking problems. The organisers wanted to know what the Nordic societies had done, and with what effect. While changing beverage choices has been a recurrent topic in Nordic policy, there was however not
enough published evidence to make claims about the underlying reasoning or any success over time. > > > > Read More