Alcohol policy – a risky business

Last Friday, the UK Government released its new Alcohol Strategy. It outlined plans to more strictly regulate late-night alcohol retail while signalling to the drinks industry that it should do more to tackle excessive consumption through voluntary agreements. However, it’s headline-grabbing provision was the introduction of minimum unit pricing to tackle binge drinking.

As I’ve argued elsewhere, minimum unit pricing represents a step change in policy approaches to alcohol by reframing it as ‘no ordinary commodity’. Champagne corks must be popping at the headquarters of the many alcohol health organisations who have long campaigned for just such a shift. Or perhaps not. Maybe they went for the Perrier … with a twist of lemon. Just this once. > > > > Read More

Last call: Review looks to address culture of alcohol, boozing by British lawmakers

British lawmakers have been known to get rowdy during debates. They also have been known to fall down drunk during a vote, headbutt colleagues in a drunken brawl, and run up 50,000 pound ($80,000) tabs for food and drink.

But in what could signal a last call for drunken debauchery on the Parliamentary Estate, Britain’s House of Commons is mulling new rules on lawmakers’ libations amid a broader effort by the government to curb drinking.

The crackdown could come after a review that was reportedly ordered by the speaker of the House of Commons shortly after a lawmaker, Eric Joyce, admitted he was “hammered” on red wine when he headbutted two Conservative rivals, punched another and assaulted a member of his own Labour Party in a frenzied brawl at Strangers’ bar in Parliament. > > > > Read More

Global Actions March 28, 2012

Key Recent Milestones:

· Vietnam: The Vietnam Beer Alcohol Beverage Association (VBA) and The International Center for Alcohol Policies (ICAP) launched a marketing code for wine and spirits in Vietnam with a ceremony on March 20 in Hanoi. View photos from the event.

· United States: The World Federation of Advertisers (WFA) held its Global Marketing Conference in New York, New York. The conference brought together leaders in the global and US advertiser community, including speakers from A-B InBev, The Coca-Cola Company, L'Oreal, Unilever and Luta. Click here for more information.

Global Actions in Focus: Progress in Russia

In March, ICAP held a Master Class in Moscow for industry stakeholders from Russia and Ukraine as part of its effort to build capacity across the alcohol industry.

“The master class was an opportunity for ICAP to work on capacity building for industry, discuss what industry can do to support the WHO global strategy, ICAP’s initiative around drinking and driving being undertaken with an NGO in Russia called Social Projects, and to highlight ICAP’s current work on noncommercial alcohol in nine countries, including Russia,” said ICAP’s Senior Vice President Marjana Martinic.

Unrecorded alcohol accounts for a significant portion of the overall volume of alcohol beverages consumed in Russia, particularly in small towns and rural areas. The problem of harmful drinking is widespread in Russia. Global Actions’ pilot study looked at sale procedures, product quality, consumption patterns, and related health and social consequences.

“Given Russia’s regional diversity and the specific features that unrecorded alcohol exhibits in different local contexts, we are now in the process of expanding the scope of our research agenda,” said ICAP’s Guillermo Cantor. “In this new stage, we are focusing our attention on external factors that drive the production and consumption of illicit alcohol.”

In addition to the pilot study executive summary, Russian translations have been completed of several ICAP documents. The Dublin Principles, ICAP Toolkit on Evaluation, and Quick Reference Guide to the ICAP Blue Book are now available in Russian.

What’s Happening Next:

· The European Advertising Standards Alliance (EASA) March 2012 advertising self-regulation workshop will be held on March 28. Sponsors include the International Center for Alcohol Policies. Click here for more details.

· Vietnam: On April 27 in Hanoi, Global Actions Vietnam will hold a seminar to present results of the first noncommercial alcohol study.

Alcohol and NCDs - need for response to WHO consultation

he Global Alcohol Policy Alliance has called for civil society and Member States of the World Health Organization (WHO) to ask that reduced alcohol consumption be reinstated among the global priority targets for prevention and control of non-communicable diseases (NCD). A consultation is open until 19 Arpil. > > > > Read More

Epidemiology and Pathophysiology of Alcohol and Breast Cancer: Update 2012

To update epidemiological data on alcohol and breast cancer, with special emphasis on light alcohol consumption, and to review mechanisms of alcohol mediated mammary carcinogenesis.

For epidemiological data, in November 2011 we performed a literature search in various bibliographic databases, and we conducted a meta-analysis of data on light alcohol drinking. Relevant mechanistic studies were also reviewed to November 2011.

A significant increase of the order of 4% in the risk of breast cancer is already present at intakes of up to one alcoholic drink/day. Heavy alcohol consumption, defined as three or more drinks/day, is associated with an increased risk by 40–50%. This translates into up to 5% of breast cancers attributable to alcohol in northern Europe and North America for a total of approximately 50 000 alcohol-attributable cases of breast cancer worldwide. Up to 1–2% of breast cancers in Europe and North America are attributable to light drinking alone, given its larger prevalence in most female populations when compared with heavy drinking. Alcohol increases estrogen levels, and estrogens may exert its carcinogenic effect on breast tissue either via the ER or directly. Other mechanisms may include acetaldehyde, oxidative stress, epigenetic changes due to a disturbed methyl transfer and decreased retinoic acid concentrations associated with an altered cell cycle.

Women should not exceed one drink/day, and women at elevated risk for breast cancer should avoid alcohol or consume alcohol occasionally only.


Read Full Abstract

Request Reprint E-Mail: helmut_karl.seitz@urz.uni-heidelberg.de

White matter volume in alcohol use disorders: a meta-analysis

Atrophy of brain white matter (WM) often is considered a signature injury of alcohol use disorders (AUDs). However, investigations into AUD-related changes in WM volume have yielded complex findings that are difficult to synthesize in a narrative review.

The objective of this study was to obtain an averaged effect size (ES) for WM volume reduction associated with AUD diagnosis and to test potential moderators of ES.

Study inclusion criteria were: (1) English language; (2) peer reviewed; (3) published before December 2011; (4) use of magnetic resonance imaging (MRI); (5) human participants; (6) inclusion of AUD group; (7) inclusion of non-AUD comparison group; and (8) reporting or testing of total or cerebral WM volume. Moderators included study design, MRI methodology and AUD characteristics.

Nineteen studies with a total of 1302 participants (70% male) were included, and calculated ESs were confirmed by the corresponding author for 12 studies. The magnitude of the averaged ES adjusted for small sample bias (Hedges' g) for WM reduction in AUDs was 0.304 (standard error = 0.134, range = −0.57–1.21).

Hierarchical linear modeling indicated that the overall ES differed significantly from 0, t(18) = 2.257, P = 0.037, and that the distribution of the 19 ESs showed significant heterogeneity beyond sampling error, χ²(18) = 52.400, P < 0.001. Treatment-seeking status and length of abstinence were significant moderators of ES distribution.

These results are suggestive of WM recovery with sustained abstinence and point to the need for further investigation of factors related to treatment-seeking status.

Read Full Abstract

Request Reprint E-Mail: mmonnig@mrn.org

Baclofen effects on alcohol seeking, self-administration and extinction of seeking responses in a within-session design in baboons

Baclofen, a gamma-aminobutyric acid_B receptor agonist, is currently under investigation as a potential treatment to prevent relapse to drinking in alcohol-dependent persons.

In the current study, two groups of baboons were trained under a chained schedule of reinforcement (CSR), with three linked components, which were each correlated with different response requirements and cues. Fulfilling the requirement in the second link initiated the third link where either alcohol (n = 4) or a preferred non-alcoholic beverage (Tang, n = 5) was available for self-administration; failure to complete the response requirement in Link 2 ended the session (no access to alcohol or Tang). Seeking responses in Link 2 were used as indices of the motivational processes thought to be involved in relapse. The effects of baclofen (0.1–2.4 mg/kg) were examined under conditions with alcohol or Tang access and under extinction.

Under the CSR, baclofen (1.8 and 2.4 mg/kg) significantly decreased (P < 0.05) alcohol self-administration responses and total g/kg alcohol intake.

In contrast, only the highest dose of baclofen (2.4 mg/kg) reduced Tang self-administration and consumption.

Under within-session extinction conditions, baclofen (1.8 and 2.4 mg/kg) facilitated extinction of responding for both alcohol and Tang, particularly during the first 10 minutes of extinction.

Baclofen may be effective in reducing craving and alcohol drinking, although the facilitation of extinction and suppression of both alcohol and Tang self-administration by baclofen suggests these effects may be related to a more general suppression of consummatory and conditioned behaviors.

Read Full Abstract

Request Reprint E-Mail: anduke@wfubmc.edu

Medications development to treat alcohol dependence: a vision for the next decade

More than 76 million people world-wide are estimated to have diagnosable alcohol use disorders (AUDs) (alcohol abuse or dependence), making these disorders a major global health problem.

Pharmacotherapy offers promising means for treating AUDs, and significant progress has been made in the past 20 years. The US Food and Drug Administration approved three of the four medications for alcoholism in the last two decades.

Unfortunately, these medications do not work for everyone, prompting the need for a personalized approach to optimize clinical benefit or more efficacious medications that can treat a wider range of patients, or both.

To promote global health, the potential reorganization of the National Institutes of Health (NIH) must continue to support the National Institute on Alcohol Abuse and Alcoholism's (NIAAA's) vision of ensuring the development and delivery of new and more efficacious medications to treat AUDs in the coming decade.

To achieve this objective, the NIAAA Medications Development Team has identified three fundamental long-range goals: (1) to make the drug development process more efficient; (2) to identify more efficacious medications, personalize treatment approaches, or both; and (3) to facilitate the implementation and adaptation of medications in real-world treatment settings. These goals will be carried out through seven key objectives.

This paper describes those objectives in terms of rationale and strategy. Successful implementation of these objectives will result in the development of more efficacious and safe medications, provide a greater selection of therapy options and ultimately lessen the impact of this devastating disorder.

Read Full Abstract

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

The Drunken Self: The Five-Factor Model as an Organizational Framework for Characterizing Perceptions of One's Own Drunkenness

Existing literature supports the use of the five-factor model (FFM) personality dimensions (i.e., Neuroticism, Extraversion, Agreeableness, Intellect, and Conscientiousness) as a comprehensive representation of mood, affect, and behavior. This study evaluated the use of the FFM as an organizational framework for understanding self-reported perceptions of drunkenness (i.e., mood, affect, and behavior associated with alcohol intoxication).

Cross-sectional data were obtained through an online survey of college student drinkers (N = 988; 50% male, 85% white, mean age = 18.2) in an Introductory Psychology course at a large, mid-western university. Participants reported on their perceptions of their sober and drunk “personalities” by rating items from Goldberg's International Personality Item Pool.

Confirmatory factor analysis showed that sober and drunk personality structures fit the data equally well. On average, differences between perceived drunken and sober personality were pervasive; each of the 5 factors differed as a function of drunk versus sober state with perceived drunken personality associated with (in order of effect size) less conscientiousness, less intellect, less agreeableness, more extraversion, and less neuroticism. These general patterns varied by sex and drinking pattern.

Findings support the use of the FFM as a framework for organizing self-reported perceptions of global changes in “personality” that occur under intoxication.

Read Full Abstract

Request Reprint E-Mail: rpwpp9@mail.missouri.edu

Opposing Actions of Ethanol and Nicotine on MicroRNAs are Mediated by Nicotinic Acetylcholine Receptors in Fetal Cerebral Cortical–Derived Neural Prog

Ethanol (EtOH) and nicotine are often co-abused. However, their combined effects on fetal neural development, particularly on fetal neural stem cells (NSCs), which generate most neurons of the adult brain during the second trimester of pregnancy, are poorly understood. We previously showed that EtOH influenced NSC maturation in part, by suppressing the expression of specific microRNAs (miRNAs). Here, we tested in fetal NSCs the extent to which EtOH and nicotine coregulated known EtOH-sensitive (miR-9, miR-21, miR-153, and miR-335), a nicotine-sensitive miRNA (miR-140-3p), and mRNAs for nicotinic acetylcholine receptor (nAChR) subunits. Additionally, we tested the extent to which these effects were nAChR dependent.

Gestational day 12.5 mouse fetal murine cerebral cortical–derived neurosphere cultures were exposed to EtOH, nicotine, and mecamylamine, a noncompetitive nAChR antagonist, individually or in combination, for short (24 hour) and long (5 day) periods, to mimic exposure during the in vivo period of neurogenesis. Levels of miRNAs, miRNA-regulated transcripts, and nAChR subunit mRNAs were assessed by quantitative reverse transcription polymerase chain reaction.

EtOH suppressed the expression of known EtOH-sensitive miRNAs and miR-140-3p, while nicotine at concentrations attained by cigarette smokers induced a dose-related increase in these miRNAs. Nicotine's effect was blocked by EtOH and by mecamylamine. Finally, EtOH decreased the expression of nAChR subunit mRNAs and, like mecamylamine, prevented the nicotine-associated increase in α4 and β2 nAChR transcripts.

EtOH and nicotine exert mutually antagonistic, nAChR-mediated effects on teratogen-sensitive miRNAs in fetal NSCs. These data suggest that concurrent exposure to EtOH and nicotine disrupts miRNA regulatory networks that are important for NSC maturation.

Read Full Abstract

Request Reprint E-Mail: miranda@medicine.tamhsc.edu

Delays in Auditory Processing Identified in Preschool Children with FASD

Both sensory and cognitive deficits have been associated with prenatal exposure to alcohol; however, very few studies have focused on sensory deficits in preschool-aged children. As sensory skills develop early, characterization of sensory deficits using novel imaging methods may reveal important neural markers of prenatal alcohol exposure.

Participants in this study were 10 children with a fetal alcohol spectrum disorder (FASD) and 15 healthy control (HC) children aged 3 to 6 years. All participants had normal hearing as determined by clinical screens. We measured their neurophysiological responses to auditory stimuli (1,000 Hz, 72 dB tone) using magnetoencephalography (MEG). We used a multidipole spatio-temporal modeling technique to identify the location and timecourse of cortical activity in response to the auditory tones. The timing and amplitude of the left and right superior temporal gyrus sources associated with activation of left and right primary/secondary auditory cortices were compared across groups.

There was a significant delay in M100 and M200 latencies for the FASD children relative to the HC children (p = 0.01), when including age as a covariate. The within-subjects effect of hemisphere was not significant. A comparable delay in M100 and M200 latencies was observed in children across the FASD subtypes.

Auditory delay revealed by MEG in children with FASDs may prove to be a useful neural marker of information processing difficulties in young children with prenatal alcohol exposure. The fact that delayed auditory responses were observed across the FASD spectrum suggests that it may be a sensitive measure of alcohol-induced brain damage. Therefore, this measure in conjunction with other clinical tools may prove useful for early identification of alcohol affected children, particularly those without dysmorphia.

Read Full Abstract

Request Reprint E-Mail: jstephen@mrn.org

Formation of Phosphatidylethanol and Its Subsequent Elimination During an Extensive Drinking Experiment Over 5 Days

For almost 30 years, phosphatidylethanol (PEth) has been known as a direct marker of alcohol consumption. This marker stands for consumption in high amounts and for a longer time period, but it has been also detected after 1 high single intake of ethanol (EtOH). The aim of this study was to obtain further information about the formation and elimination of PEth 16:0/18:1 by simulating extensive drinking.

After 3 weeks of alcohol abstinence, 11 test persons drank an amount of EtOH leading to an estimated blood ethanol concentration of 1 g/kg on each of 5 successive days. After the drinking episode, they stayed abstinent for 16 days with regular blood sampling. PEth 16:0/18:1 analysis was performed using liquid chromatography-tandem mass spectrometry (high-performance liquid chromatography 1100 system and QTrap 2000 triple quadrupole linear ion trap mass spectrometer. Values of blood alcohol were obtained using a standardized method with headspace gas chromatography flame ionization detector.

Maximum measured concentrations of EtOH were 0.99 to 1.83 g/kg (mean 1.32 g/kg). These values were reached 1 to 3 hours after the start of drinking (mean 1.9 hours). For comparison, 10 of 11 volunteers had detectable PEth 16:0/18:1 values 1 hour after the start of drinking, ranging from 45 to 138 ng/ml PEth 16:0/18:1. Over the following days, concentrations of PEth 16:0/18:1 increased continuously and reached the maximum concentrations of 74 to 237 ng/ml between days 3 and 6.

This drinking experiment led to measurable PEth concentrations. However, PEth 16:0/18:1 concentrations stayed rather low compared with those of alcohol abusers from previous studies.

Read Full Abstract

Request Reprint E-Mail: heike.gnann@uniklinik-freiburg.de

Cognitive Barriers to Readiness to Change in Alcohol-Dependent Patients

Patients' personal investment and readiness to change have proved to be a prerequisite for the successful treatment of alcohol addiction. The aim of this study was to determine the contribution of cognitive functions to the motivation process to abandon maladjusted behavior in favor of a healthier lifestyle.

An adapted version of the “readiness to change” questionnaire was completed by 31 alcohol-dependent patients after detoxification and at alcohol treatment entry. This tool is designed to assess the 3 main stages of motivation to change regarding alcohol consumption: precontemplation (substance abuse and no intention to stop drinking), contemplation (strong intention to change habits but ambivalent behavior), and action (cessation of excessive alcohol consumption and behavioral changes for healthier habits) stages. Patients and 37 healthy controls also underwent an extensive neuropsychological battery including episodic memory, metamemory, executive functions, and decision-making assessment.

When alcohol-dependent patients were considered as a group, the mean score on the action subscale was significantly higher than the precontemplation and contemplation ones. Nevertheless, when the stage of change reached by each patient was considered individually, we found that some alcohol-dependent patients were still in the earlier precontemplation and contemplation stages. Stepwise regression analysis revealed links between impaired memory and executive functions and low motivation, and between good decision-making skills and high motivation.

Our results suggest that a set of complementary cognitive abilities is needed to achieve awareness and resolve ambivalence toward alcohol addiction, which is essential for activating the desire to change problematic behavior.

Read Full Abstract

Request Reprint E-Mail: helene.beaunieux@unicaen.fr

Letter - Health benefits of moderate alcohol consumption How good is the science?

Ronksley and colleagues asserted that the association between moderate alcohol consumption and reduced mortality risk was “beyond question.”1 We reviewed all 67 studies that generated the 84 articles in their meta-analysis. All but two had at least one of six serious methodological problems, and these two had mixed findings (figure⇓); see http://carbc.ca/Portals/0/News/FeatureSupplement201203.pdf for bibliography) . . . . .


Read Full Text (PDF)

Supplementary material to a Letter published by the British Medical Journal in February 2012 (PDF)

Europeans are world's heaviest drinkers: WHO report

People in Europe drink more alcohol than in any other part of the world, downing the equivalent of 12.5 liters of pure alcohol a year or almost three glasses of wine a day, according to report by the World Health Organization and the European Commission. > > > > Read More

Liquid Courage or Liquid Fear: Alcohol Intoxication and Anxiety Facilitate Physical Aggression

Participants were 138 male social drinkers between 18 and 30 years of age from a university community in the southeastern United States in 2000.

Trait and state anxiety was measured using the Trait Anxiety Inventory and the Facial Action Coding System, respectively. Participants consumed an alcoholic or nonalcoholic control beverage and completed a shock-based aggression task.

Regression analysis indicated that alcohol-facilitated elevations in anxiety mediated the relation between alcohol consumption and aggression and that trait anxiety and physical provocation moderated this effect.

Implications and limitations of this study are noted and future research directions are suggested.



Read Full Abstract

Request Reprint E-Mail: parrott@gsu.edu

Binge Drinking Trajectories from Adolescence to Young Adulthood: The Effects of Peer Social Network

This study investigates an association between social network characteristics and binge drinking from adolescence to young adulthood, utilizing National Longitudinal Study of Adolescent Health (n = 7,966) and employing social network and longitudinal analysis.

Lower integration and socialization with alcohol-using peers had immediate risks of binge drinking during adolescence; however, over time, the effects of socialization with alcohol-using peers had the most dramatic reduction.

The most prestigious adolescents had the highest longitudinal risks of binge drinking, although they had no immediate risk.

Alcohol consumption-related interventions overlooking longitudinal dynamics of social networks may not effectively prevent adolescents from binge drinking in young adulthood.



Read Full Abstract

Request Reprint E-Mail: hahm@bu.edu

Alcohol consumption and risk of pre-diabetes and type 2 diabetes development in a Swedish population

Alcohol is a potential risk factor of Type 2 diabetes. However, more detailed information on effects of alcohol types and early phases of Type 2 diabetes development seems warranted. The aim of this study was to investigate the influence of alcohol consumption and specific alcoholic beverages on the risk of developing pre-diabetes and Type 2 diabetes in middle-aged Swedish men and women.

Subjects, who at baseline had normal glucose tolerance (2070 men and 3058 women) or pre-diabetes (70 men and 41 women), aged 35–56 years, were evaluated in this cohort study. Logistic regression was performed to estimate the risk [odds ratio (OR) and 95% confidence interval (CI)] to develop pre-diabetes and Type 2 diabetes at 8–10 years follow-up, in relation to self-reported alcohol intake at baseline. Adjustment was performed for several risk factors.

Total alcohol consumption and binge drinking increased the risk of pre-diabetes and Type 2 diabetes in men (OR 1.42, 95% CI 1.00–2.03 and OR 1.67, 95% CI 1.11–2.50, respectively), while low consumption decreased diabetes risk in women (OR 0.41, 95% CI 0.22–0.79). Men showed higher risk of pre-diabetes with high beer consumption (OR 1.84, 95% CI 1.13–3.01) and of Type 2 diabetes with high consumption of spirits (OR 2.03, 95% CI 1.27–3.24). Women showed a reduced risk of pre-diabetes with high wine intake (OR 0.66, 95% CI 0.43–0.99) and of Type 2 diabetes with medium intake of both wine and spirits (OR 0.46, 95% CI 0.24–0.88 and OR 0.55, 95% CI 0.31–0.97, respectively), whereas high consumption of spirits increased the pre-diabetes risk(OR 2.41, 95% CI 1.47–3.96).

High alcohol consumption increases the risk of abnormal glucose regulation in men. In women the associations are more complex: decreased risk with low or medium intake and increased risk with high alcohol intake.

Read Full Abstract

Request Reprint E-Mail: claes.ostensson@karolinska.se

Alcohol-associated risks for young adults with Type 1 diabetes: a narrative review

To undertake a narrative review of the impact and pattern of alcohol consumption in young adults with Type 1 diabetes.

Data sources: MEDLINE, EMBASE, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of the European Association for the Study of Diabetes, the American Diabetes Association and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, UK Clinical Research Network, scrutiny of bibliographies of retrieved papers and contact with experts in the field. Inclusion criteria: relevant studies of any design of alcohol consumption and young adults with Type 1 diabetes (age 14–25 years) were included. The key outcomes were the quantity, pattern and impact of alcohol consumption, the effect on diabetes control and the effect of interventions to minimize the risks of alcohol for this population.

Six articles and two conference abstracts met the inclusion criteria. There were six cross-sectional studies, one qualitative study and one within-subjects design study. Quality of studies was variable. Alcohol use amongst young adults with Type 1 diabetes was reported to be common and potentially harmful. There was a paucity of evidence on interventions to minimize the risks of alcohol in this target group.

Research is required to understand the social context of alcohol consumption in this population with a view to developing appropriate interventions to minimize the risks associated with its use.

Read Full Abstract

Request Reprint E-Mail: k.barnard@southampton.ac.uk

EDITORIAL - Alcohol limits in older people

The recommended number of alcoholic drinks per day, occasion and week for people aged 65+ years is based largely on good clinical practice.

However, the number of grams of alcohol contained in a standard drink varies by country.

Acquisition of the scientific base for developing globally uniform guidelines should be prioritized.


Read Full Text (PDF)

Press Release - GPs should advise drinkers to keep a daily record of their drinking

The new UK alcohol strategy includes a plan to ensure that General Practitioners (GPs) advise heavy drinkers to cut down (The Government’s Alcohol Strategy, 23 March 2012, downloadable from http://www.homeoffice.gov.uk/publications/). There is good evidence that this can reduce how much people drink. The big question is, what should GPs say to their patients?

A new study published online by the scientific journal Addiction analysed the advice given by GPs in all the major clinical trials evaluating this kind of advice, looking for common components linked to the largest reductions in drinking across the different studies.

Among the many different components of the advice, such as providing information on the harms of excessive drinking, trying to boost motivation and self-confidence, and advising on avoidance of social cues for drinking, they found that the most effective piece of advice was to encourage the patient to monitor his or her alcohol consumption, typically by keeping a daily record. > > > > Read More

Identification of behaviour change techniques to reduce excessive alcohol consumption

Interventions to reduce excessive alcohol consumption have a small but important effect but a better understanding of their ‘active ingredients’ is needed.

This study aimed to (i) develop a reliable taxonomy of behaviour change techniques (BCTs) used in interventions to reduce excessive alcohol consumption (not to treat alcohol dependence), and (ii) to assess whether use of specific BCTs in brief interventions might be associated with improved effectiveness.

A selection of guidance documents and treatment manuals, identified via expert consultation, were analysed into BCTs by two coders. The resulting taxonomy of BCTs was applied to the Cochrane Review of brief alcohol interventions, and the associations between the BCTs and effectiveness were investigated using meta-regression.

Forty-two BCTs were identified, 34 from guidance documents and an additional eight from treatment manuals, with average inter-rater agreement of 80%. Analyses revealed that brief interventions that included the BCT ‘prompt self-recording’ (p=0.002) were associated with larger effect sizes.

It is possible to reliably identify specific BCTs in manuals and guidelines for interventions to reduce excessive alcohol consumption. In brief interventions, promoting self-monitoring is associated with improved outcomes. More research is needed to identify other BCTs or groupings of BCTs that can produce optimal results in brief interventions and to extend the method to more intensive interventions and treatment of alcohol dependence.

Read Full Abstract

Request Reprint E-Mail: s.michie@ucl.ac.uk

The role of biogenic amine signaling in the bed nucleus of the stria terminals in alcohol abuse

There is a growing body of evidence that suggests that stress and anxiety can influence the development of alcohol use disorders. This influence is believed to be due in part to persistent adaptations in discrete brain regions that underlie stress responsivity.

One structure that has been proposed to be a site of important neuroadaptations underlying this behavior is the extended amygdala.

The extended amygdala is a series of extensively inter-connected limbic structures including the central nucleus of the amygdala (CeA) and the bed nucleus of the stria terminalis (BNST). These structures are critical regulators of behavioral and physiological activation associated with anxiety.

Additionally, numerous reports have suggested that these regions are involved in increased drinking behavior associated with chronic alcohol exposure and withdrawal.

The focus of this review will be to discuss the role of the BNST in regulation of behavior, to provide some insight in to the circuitry of the BNST, and to discuss the actions of the biogenic amines, serotonin, dopamine and norepinephrine, in the BNST.



Read Full Abstract

Request Reprint E-Mail: tkash@email.unc.edu

Targeting dynorphin/kappa opioid receptor systems to treat alcohol abuse and dependence

This review represents the focus of a symposium that was presented at the “Alcoholism and Stress: A Framework for Future Treatment Strategies” conference in Volterra, Italy on May 3–6, 2011 and organized/chaired by Dr. Brendan M. Walker. The primary goal of the symposium was to evaluate and disseminate contemporary findings regarding the emerging role of kappa-opioid receptors (KORs) and their endogenous ligands dynorphins (DYNs) in the regulation of escalated alcohol consumption, negative affect and cognitive dysfunction associated with alcohol dependence, as well as DYN/KOR mediation of the effects of chronic stress on alcohol reward and seeking behaviors. Dr. Glenn Valdez described a role for KORs in the anxiogenic effects of alcohol withdrawal. Dr. Jay McLaughlin focused on the role of KORs in repeated stress-induced potentiation of alcohol reward and increased alcohol consumption. Dr. Brendan Walker presented data characterizing the effects of KOR antagonism within the extended amygdala on withdrawal-induced escalation of alcohol self-administration in dependent animals. Dr. Georgy Bakalkin concluded with data indicative of altered DYNs and KORs in the prefrontal cortex of alcohol dependent humans that could underlie diminished cognitive performance. Collectively, the data presented within this symposium identified the multifaceted contribution of KORs to the characteristics of acute and chronic alcohol-induced behavioral dysregulation and provided a foundation for the development of pharmacotherapeutic strategies to treat certain aspects of alcohol use disorders.



Read Full Abstract

Request Reprint E-Mail: b_walker@wsu.edu

A review of the interactions between alcohol and the endocannabinoid system: Implications for alcohol dependence and future directions for research

Over the past fifty years a significant body of evidence has been compiled suggesting an interaction between the endocannabinoid (EC) system and alcohol dependence.

However, much of this work has been conducted only in the past two decades following the elucidation of the molecular constituents of the EC system that began with the serendipitous discovery of the cannabinoid 1 receptor (CB1).

Since then, novel pharmacological and genetic tools have enabled researchers to manipulate select components of the EC system, to determine their contribution to the motivation to consume ethanol.

From these preclinical studies, it is evident that CB1 contributes the motivational and reinforcing properties of ethanol, and chronic consumption of ethanol alters EC transmitter levels and CB1 expression in brain nuclei associated with addiction pathways.

These results are augmented by in vitro and ex vivo studies showing that acute and chronic treatment with ethanol produces physiologically relevant alterations in the function of the EC system.

This report provides a current and comprehensive review of the literature regarding the interactions between ethanol and the EC system.

We begin be reviewing the studies published prior to the discovery of the EC system that compared the behavioral and physiological effects of cannabinoids with ethanol in addition to cross-tolerance between these drugs.

Next, a brief overview of the molecular constituents of the EC system is provided as context for the subsequent review of more recent studies examining the interaction of ethanol with the EC system.

These results are compiled into a summary providing a scheme for the known changes to the components of the EC system in different stages of alcohol dependence.

Finally, future directions for research are discussed.



Read Full Abstract

Request Reprint E-Mail: woodward@musc.edu

Increased amplitude of P3 event-related potential in young binge drinkers

The aim of the present study was to determine how binge drinking (BD) affects brain functioning in male and female university students during the performance of a visual discrimination task.

Thirty two binge drinkers and 53 controls (non binge drinkers), with no history of other drug use, personal or family history of alcoholism or psychopathological disorders, were selected. Event-related potentials (ERPs) were recorded during the performance of a visual oddball task. The latency and amplitude of the N2 and P3b components of the ERPs were analyzed.

There were no differences between the groups in behavioral measures, but P3b amplitudes were significantly larger in binge drinkers than controls.

This may suggest the presence of anomalies in neural processes mediating attention processing, or an imbalance (increased) of neuronal activity in P3b generators caused by the presence of BD pattern for a long time.



Read Full Abstract

Request Reprint E-Mail: alberto.crego@usc.es

Transgenic over expression of nicotinic receptor alpha 5, alpha 3, and beta 4 subunit genes reduces ethanol intake in mice

Abuse of alcohol and smoking are extensively co-morbid. Some studies suggest partial commonality of action of alcohol and nicotine mediated through nicotinic acetylcholine receptors (nAChRs).

We tested mice with transgenic over expression of the alpha 5, alpha 3, beta 4 receptor subunit genes, which cluster on human chromosome 15, that were previously shown to have increased nicotine self-administration, for several responses to ethanol.

Transgenic and wild-type mice did not differ in sensitivity to several acute behavioral responses to ethanol. However, transgenic mice drank less ethanol than wild-type in a two-bottle (ethanol vs. water) preference test.

These results suggest a complex role for this receptor subunit gene cluster in the modulation of ethanol's as well as nicotine's effects.


Read Full Abstract

Request Reprint E-Mail: mara.dierssen@crg.es

Repeated exposure of the posterior ventral tegmental area to nicotine increases the sensitivity of local dopamine neurons to the stimulating effects o

Clinical evidence indicates a frequent co-morbidity of nicotine and alcohol abuse and dependence. The posterior ventral tegmental area (pVTA) appears to support the reinforcing and dopamine-stimulating effects of both drugs.

The current study tested the hypothesis that repeated exposure of the pVTA to one drug would increase the sensitivity of local dopamine neurons to the stimulating effects of the other drug.

Female Wistar rats received repeated daily microinjections of either 100 μM nicotine or vehicle directly into the pVTA for 7 days. On the 8th day, rats received microinjections of either vehicle or ethanol (100 or 200 mg%) into the pVTA while extracellular dopamine samples were collected from the ipsilateral nucleus accumbens shell (NACsh) with microdialysis. Another experiment tested the effects of challenge microinjections of 200 μM nicotine in the pVTA on extracellular dopamine levels in the NACsh following 7 daily pretreatments with 200 mg% ethanol in the pVTA.

Nicotine pretreatments increased the dopamine-stimulating effects of ethanol in the pVTA (100 mg% ethanol: 115% vs 160% of baseline in the vehicle and nicotine groups, respectively, p < 0.05; 200 mg% ethanol: 145% vs 190% of baseline in the vehicle and nicotine groups, respectively, p < 0.05).

In contrast, ethanol pretreatments did not alter the stimulating effects of nicotine in the pVTA.

The results suggest that repeated exposure of the pVTA to nicotine increased the response of local dopamine neurons to the stimulating effects of ethanol, whereas repeated exposure of the pVTA to ethanol did not alter the responses of pVTA dopamine neurons to nicotine.

Read Full Abstract

Request Reprint E-Mail: zding@iupui.edu

Toxicological effects of red wine, orange juice, and other dietary SULT1A inhibitors via excess catecholamines

SULT1A enzymes protect humans from catecholamines, but natural substances in many foods have been found to inhibit these enzymes in vitro. Given the hormonal roles of catecholamines, any in vivo SULT1A inhibition could have serious consequences.

This paper uses a re-analysis of published data to confirm that SULT1A inhibitors have effect in vivo in at least some patients.

Nineteen studies are cited that show ingestion of SULT1A inhibitors leading to catecholamine increases, blood pressure changes, migraine headaches, or atrial fibrillation. SULT1A inhibition does not create the catecholamines, but prevents normal catecholamine deactivation. Susceptible patients probably have lower-activity SULT1A alleles.

The paper discusses new hypotheses that SULT1A inhibition can cause “holiday heart” arrhythmias and type 2 diabetes in susceptible patients.

Subgroup analysis based on SULT1A alleles, and addition of a catecholamine source, should improve the consistency of results from tests of SULT1A inhibitors.

SULT1A inhibition may be a key contributor to cheese-induced migraines (via annatto), false positives in metanephrine testing, and the cardiovascular impacts of recreational alcohols.


Read Full Abstract
Request Reprint E-Mail: eaglek2011@gmail.com

Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction: the Health Professionals

The aim of this study was to examine the association between long-term alcohol consumption, alcohol consumption before and after myocardial infarction (MI), and all-cause and cardiovascular mortality among survivors of MI.

The Health Professionals Follow-up Study (HPFS) is a prospective cohort study of 51 529 US male health professionals. From 1986 to 2006, 1818 men were confirmed with incident non-fatal MI. Among MI survivors, 468 deaths were documented during up to 20 years of follow-up. Long-term average alcohol consumption was calculated beginning from the time period immediately before the first MI and updated every 4 years afterward. Cox proportional hazards were used to estimate the multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Compared with non-drinkers, the multivariable-adjusted HRs for all-cause mortality were 0.78 (95% CI: 0.62–0.97) for 0.1–9.9 g/day, 0.66 (95% CI: 0.51–0.86) for 10.0–29.9 g/day, and 0.87 (95% CI: 0.61–1.25) for ≥30 g/day (P_quadratic= 0.006). For cardiovascular mortality, the corresponding HRs were 0.74 (95% CI: 0.54–1.02), 0.58 (95% CI: 0.39–0.84), and 0.98 (95% CI: 0.60–1.60), P_quadratic= 0.003. These findings were consistent when restricted to pre- and post-MI alcohol assessments. In subgroup analyses, moderate alcohol consumption was inversely associated with mortality among men with non-anterior infarcts, and among men with mildly diminished left ventricular function.

Long-term moderate alcohol consumption is inversely associated with all-cause and cardiovascular mortality among men who survived a first MI. This U-shaped association may be strongest among individuals with less impaired cardiac function after MI and should be examined further.

Read Full Abstract

Request Reprint E-Mail: jennifer.pai@channing.harvard.edu

EUCAM March News Update

This is the fourteenth in a monthly series of EUCAM news updates. The following news items have been published on www.EUCAM.info in March of 2012:

UK´s new Alcohol Strategy: Does it go far enough?

03/27/12 - Last week the British government published it’s hotly debated Alcohol Strategy. Among the commitments of the strategy, are plans to introduce a floor pricing of 40 pence per alcoholic unit, as well as plans to ban two-for-one promotions to combat binge drinking. The strategy has been met with mixed reactions, particularly concerning its approach to advertising and the reliance on the responsibilities of the alcohol industry.

Read the full article >>


British administration to ban advertising pushing cheap alcohol

03/08/12 - British supermarkets might could soon be banned from advertising cheap alcohol, if current Coalition plans go through. This would imply an end to TV and poster ads pushing cheap alcohol.

Read the full article >>


Australian alcohol marketing now under scrutiny by independent watchdog

03/13/12 - Australia just got their first fully independent alcohol marketing watchdog. The Alcohol Advertising Review Board (AARB) is an innovative new project from the McCusker Centre for Action on Alcohol and Youth in collaboration with Cancer Council Western Australia. The AARB will judge community complaints about alcohol advertising and will deliver determinations, free of industry influence.

Read the full article >>


Brazillian government no longer devided on alcohol sale during World Cup?

03/20/12 - While it seems that the matter is still widely unresolved, Brazil’s sport minister has released a reassuring statement to the FIFA that the government remains committed to approving the sale of alcohol inside World Cup stadiums.

Read the full article >>


IOGT International calls out FIFA: stop bullying and insulting Brazil

03/06/12 - IOGT International, today spread a press release condemning the world’s football governing body, FIFA, as doing the dirty work for the alcohol industry. Additionally IOGT makes the case that FIFA ignores scientific evidence and social needs, while also bullying and insulting Brazilians.

Read the full article >>


Alcohol Concern Cymru claims children exposed to alcohol advertising

03/15/12 - A new report from British health campaign group Alcohol Concern Cymru shows that children as young as 10 in Wales are more familiar with some leading alcohol brands and adverts than those for popular foods and snacks.

Read the full article >>


Link alcohol use in movies and adolescent binge drinking ‘robust’ new study claims

03/13/12 - New scientific research shows that the link between exposure of teens to alcohol consumption in movies and binge drinking is strong. This conclusion comes from a survey questioning 16.551 adolescents in Germany, Iceland, Italy, the Netherlands, Poland, and Scotland. The study also shows that the relationship between alcohol use in movies and adolescent binge drinking is the same in all six countries.

Read the full article >>


Norwegian brewers forbidden to show beer on own websites

03/01/12 - Since last month, new rulings by two state agencies prohibit Norwegian brewers from reviewing or depicting beer on their websites. The organizations in question, Aass Brewery and the Norwegian Brewery Association, are furious about what they call ´surreal´ verdicts.

Read the full article >>

Alcohol in the European Union. Consumption, harm and policy approaches

This new report uses information gathered in 2011 to update key indicators on alcohol consumption, health outcomes and action to reduce harm across the European Union (EU). It gives an overview of the latest research on effective alcohol policies, and includes data from the EU, Norway and Switzerland on alcohol consumption, harm and policy approaches. The data were collected from a 2011 survey, carried out as part of a project of the European Commission and the WHO Regional Office for Europe. The report updates the evidence base for some important areas of alcohol policy, and provides policy-makers and other stakeholders in reducing the harm done to health and society by excessive drinking with useful information to guide future action.

Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and unsafe sex. In Europe, alcohol is the third leading risk factor for disease and death after tobacco and high blood pressure.

Read Full Report (PDF)

Alcohol-Related Injuries and Alcohol Control Policy in Lithuania: Effect of the Year of Sobriety, 2008

To evaluate the changes in mortality and the years of potential life lost (YPLL) due to alcohol-related injuries, as well as the impact of alcohol-related injuries on life expectancy during the period of the implementation of comprehensive alcohol control policy in Lithuania.

Data on deaths from injuries (ICD-10 codes V01-Y98) of the able-bodied population (aged 15–64 years) during 2006–2009 were obtained from the Lithuanian Department of Statistics. Age-standardized rates of alcohol-related mortality and YPLL per 100, 000 population due to injuries and the impact of alcohol-related injuries on life expectancy were calculated. The results of forensic autopsies were the basis for the alcohol-attributable fraction.

The age-standardized YPLL/100,000 of the able-bodied population due to alcohol-related injuries was 2285.6 (4067.5 for males and 573.6 for females) in 2009. In 2009, YPLL/100,000 due to alcohol-related injuries declined by 16.3%, while due to alcohol-related traffic accidents by 51.2% when compared with 2006. However, YPLL/100, 000 due to alcohol-related suicides increased among males. A 15 to 64-year-old decedent lost an average of 21.2 years of life due to alcohol-related injuries (21.6 years on average per male and 19.1 per female). The impact of alcohol-related injuries on life expectancy decreased from 1.14 years (1.86 for males and 0.34 for females) in 2006 to 0.97 years (1.62 for males and 0.26 for females) in 2009.

The positive changes in YPLL due to alcohol-related injuries and the impact of alcohol-related injuries on life expectancy indicate successful implementation of evidence-based alcohol control measures.


Read Full Abstract

Request Reprint E-Mail: smante@centras.lt

Does family history of alcohol problems influence college and university drinking or substance use?: A meta-analytic review

Family history of alcohol use problems is a reliable determinant of alcohol use and problems in the population at large, but findings are inconsistent when this issue is examined in college and university students. No quantitative

summary of this literature has been reported to date. The purpose of this study was to conduct a meta-analysis on the effects of family history on substance use and abuse in college and university students.

A two-group contrast meta-analysis was conducted to evaluate the differences in substance use and abuse between family history –positive and –negative students pursuing higher education.

The studies that contributed data to this meta-analysis were conducted in five countries, with the majority of studies from the US.

A total of 65 published articles (53 samples) contributed data from 89,766 participants attending university or college.

Effect sizes were coded for alcohol consumption, problems, and use disorder symptoms, as well as other illegal drug use and abuse. Two independent coders calculated effect sizes and coded descriptive content about the articles, and discrepancies were reconciled. Family history was used as the grouping variable.

Family history had a minimal effect on alcohol consumption, with stronger effects on alcohol consequences (ds: 0.21-0.29), alcohol use disorder symptoms (ds: 0.24-0.27), and other drug involvement (ds: 0.34-0.86).

Relative to students without a family history of alcohol problems, students with positive family histories do not drink more, but may be at greater risk for difficulties with alcohol and drugs.

Read Full Abstract

Request Reprint E-Mail: jcelliot@syr.edu