ALCOHOL REPORTS: 6/3/12

Friday, June 8, 2012

Commentaries on Pechansky & Chandran Why don't northern American solutions to drinking and driving work in southern America? (2012)

THE ROAD MAY BE LONG, BUT YOU ARE ON YOUR WAY (pages 1207–1208) RAUL CAETANO

THE ADVOCACY FACTOR: THE IMPORTANCE OF GRASSROOTS MOVEMENTS IN SUPPORT OF DWI POLICIES (pages 1208–1209) ILANA PINSKY

DEVELOPING COUNTRIES IGNORE DRINKING AND DRIVING PROBLEMS AT THEIR OWN PERIL (pages 1209–1210 ISIDORE S. OBOT

ACHIEVING INTERNATIONAL PROGRESS ON ALCOHOL AND TRAFFIC SAFETY (pages 1210–1211) ROBERT E. MANN and CHRISTINE M. WICKENS

RESPONSE TO COMMENTARIES (pages 1211–1213) FLAVIO PECHANSKY and ARUNA CHANDRAN

Why don't northern American solutions to drinking and driving work in southern America?

While individual studies from several South American countries have shown driving while intoxicated to be a problem, there are no objective systematically collected alcohol-associated driving data obtained in most South American countries. This limits their ability to implement and enforce targeted prevention strategies, evaluate whether proven prevention efforts from North America (particularly the United States and Canada) can be transferred to the South, and to sustain momentum for the improvement of road safety by demonstrating that previously implemented legal and policy changes are effective.

The aim of this paper is to discuss the abysmal differences that exist between northern and southern American countries regarding the current status of driving while intoxicated prevention strategies—their implementation, impacts and effects—using Brazil as a case example.

We propose a three-pronged approach to close this northern–southern American gap in driving while intoxicated prevention and intervention: (a) systematic collection on road traffic crash/injury/death as well as risk factor data, (b) passage of laws without loopholes requiring compliance with blood alcohol concentration testing and (c) provision of appropriate training and equipment to the police in concomitance with vigilant enforcement.

Resources and energies must be put towards data collection, implementation of prevention strategies and enforcement in order to decrease the unacceptably high rates of these preventable driving while intoxicated deaths.

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Request Reprint E-Mail: fpechans@uol.com.br

TH-1 and TH-2 Cytokines in Stable Chronic Alcoholics

In alcoholics, the activation of Kupffer cells by gram negative bacteriae leads to an inflammatory response and cytokine secretion, which in turn activate T-lymphocytes. Possibly, Th-1 lymphocytes are activated first, followed by a Th-2 response. Th-2 cytokines, especially interleukin (IL)-13 (scarcely studied in alcoholics), may be involved in the progression to chronic stages.

The aim of the study was to analyze the relationship of Th-1 and Th-2 cytokines with liver function, alcohol consumption, nutritional status and survival.

Serum Th-1 [interferon-γ (IFN-γ)] and Th-2 cytokines (IL-4, IL-13), IL-10, IL-6 and tumor necrosis factor (TNF-α), were determined for 18 controls and 47 stable alcoholics with variable liver function impairment, who were followed-up during a median time of 90 months, a period during which 14 patients died.

IL-4 was lower among patients; no differences were observed regarding IL-6, but the remaining ILs were higher among alcoholics. IL-10 and IL-13 were even higher in cirrhotics (Z = 2.88, P = 0.004, and Z = 2.09, P = 0.037, respectively). A significant, direct, correlation was observed between IL-13 and IL-10 (ρ = 0.49, P = 0.001), and non-significant, inverse ones were observed between IFN-γ and IL-13 (ρ = −0.23), IL-4 (ρ = −0.14) and IL-10 (ρ = −0.09). IL-13 and IL-10 were inversely related with liver function and, directly with immunoglobulin A levels, but not with survival.

Serum IFN-γ values were increased in alcoholics, who also showed raised IL-13 and IL-10, but lower IL-4 levels. Given the immunomodulatory roles of IL-10 and IL-13, this increase may be interpreted as a compensatory rise of anti-inflammatory cytokines. We failed to find any relation with mortality.

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MMWR Surveillance Summaries: •Youth Risk Behavior Surveillance — United States, 2011

The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity.

In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies.

This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9–12.

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Tuesday, June 5, 2012

Do 12-step meeting attendance trajectories over 9 years predict abstinence?

This study grouped treatment-seeking individuals (n = 1825) by common patterns of 12-step attendance using 5 waves of data (75% interviewed Year 9) to isolate unique characteristics and use-related outcomes distinguishing each class profile.

The “high” class reported the highest attendance and abstention.

The “descending” class reported high baseline alcohol severity, long treatment episodes, and high initial attendance and abstinence, but by Year 5, their attendance and abstinence dropped.

The “early-drop” class, which started with high attendance and abstinence but with low problem severity, reported no attendance after Year 1.

The “rising” class, with fairly high alcohol and psychiatric severity throughout, reported initially low attendance, followed by increasing attendance paralleling their abstention.

Last, the “low” and “no” classes, which reported low problem severity and very low/no attendance, had the lowest abstention.

Female gender and high alcohol severity predicted attendance all years. Consistent with a sustained benefit for 12-step exposure, abstinence patterns aligned much like attendance profiles.

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Request Reprint E-Mail: jwitbrodt@arg.org

'Statistics on Alcohol: England 2012' confirms continuing upward admissions trend

The latest annual statistics on alcohol for England 2012 have been released by the ONS, confirming a continuing rise in alcohol-related and primary alcohol attributable hospital conditions. Alcohol-related admissions rose 11% on the previous year with primary diagnosis conditions up 2.1%.

This comes despite falls since 2004 in the proportion of adults reporting drinking alcohol. Continuing admissions - many being long term conditions - are thought to be linked to decades of rising consumption prior to 2004. Additionally indications that amongst some groups, those who are drinking are drinking more. > > > > Read More

Alcohol News - 23/2012

The Baltic Course (Estonia) - Estonian government hopes to earn 130 mln euros by raising the alcohol excise tax

The finance ministry draft law that was sent to other ministries for approval recently and that aims to increase alcohol excise tax in Estonia by 5% a year in 2013–2016 should result in a 130 million euros extra gain for the state budget, LETA/Public Broadcasting reports.

The Baltic Course (Estonia) - Estonian police increases control of drunk drivers

The Estonian police announced on Monday that starting today till the Midsummer's Day, it would hold frequent police operations to test the sobriety of drivers and calls for straightforward condemnation of drunk driving, LETA/Public Broadcasting reports.

The Scientific World Journal (Lithuania) - Trends and Social Differences in Alcohol Consumption during the Postcommunist Transition in Lithuania

The aim of the study was to evaluate the trends and social differences in consumption of various types of alcoholic beverages in Lithuania over the postcommunist transition period (1994–2010).

ABC News - Alcohol Consumption Boosts Breast Cancer Risk

A new study by the National Cancer Institute of 1,900 post-menopausal women found that consuming seven to 14 alcoholic drinks per week — in other words, one or two a day — carries a 30 percent to 60 percent increase in breast cancer risk.

The Guardian (UK) - Cut alcohol intake to just a quarter pint of beer a day, experts advise

People should drink just a half unit of alcohol daily in order to cut the number of deaths from cancer, liver disease and other conditions linked to drinking, health experts are urging.

Science Daily - Alcohol May Trigger Serious Palpitations in Heart Patients

The term "holiday heart syndrome" was coined in a 1978 study to describe patients with atrial fibrillation who experienced a common and potentially dangerous form of heart palpitation after excessive drinking, which can be common during the winter holiday season.

Ninemsn - Alcohol energy drinks spark concern

The parents of a Melbourne schoolgirl who died suddenly after consuming alcoholic energy drinks at a party want answers.

TVNZ (New Zealand) - Alcohol reform bill 'pragmatic and sensible'

The Justice Minister wants the age of people who can buy alcohol from a bottle store to be raised to 20. Judith Collins has told TV ONE's Q and A programme that she favours a split which would mean 18-year-olds could still legally drink at their local.

OCRegister (USA) - California cuts some alcohol taxes 94%

Alcoholic beverage taxes on flavored malt beverages, such as hard lemonade and flavored wines, has been cut to 20 cents a gallon from $3.30 because of a recent state appeals court ruling.

The Age (Australia) - Alcohol a bigger problem than drugs for young

THE Children's Court has sounded the alarm about the intensity of underage drinking in the community, saying that alcohol consumption - rather than drug use - is the ''big catalyst'' for youth offending in the state.

Counsel & Heal (EU/USA) - American Teens Are Less Likely than European Teens to Use Cigarettes and Alcohol

The U.S. had the second-lowest proportion of students who used tobacco and alcohol compared to their counterparts in 36 European countries, a new report indicates.

BBC News (UK) - David Nutt suggests alcohol sensors 'in every car'

Alcohol sensors should be in every car to cut drink-related road deaths and injuries, says the government's former chief drugs adviser.

Times of Malta (Malta) - Alcohol remains Malta's top problem, survey of drug, cigarette and alcohol abuse shows

Drug, alcohol and cigarette consumption among 16-year-olds in Malta has declined, but alcohol consumption, in particular, remains a problem, according to a survey of 36 countries.

Irish Times (Ireland) - Irish teens drink more but less often than average

IRISH SECONDARY school students drink alcohol less often than their European peers but consume more when they drink, according to a European survey published yesterday.

Czech Happenings (Czech Republic) - Young Czechs lead alcohol consumption standings in Europe – study

The alcohol consumption of 16-year-old Czechs is the highest in Europe, according to the European School Survey Project on Alcohol and Drugs (ESPAD) from 2011 focused on the use of addictive substances among 16-year-old Europeans, released these days.

Counsel & Heal (UK) - Hospital Admissions Due to Alcohol on a Rise in England

More and more number of people are taken to hospital for alcohol related ailments each year with a steep increase of 10 percent in the total number of alcohol consumers every year in England.

Ottawa Citizen (Canada) - The invisible victims of alcohol abuse

Children of alcoholics are often plagued by their own demons, suffering from addiction problems and anger issues and leading dysfunctional lives.

EurActiv (EU) - Parliament steps up pressure on food, beverage ads

The European Parliament has renewed calls to curb food and beverage advertising aimed at children and young people, with some MEPs even calling for a total ban on beer commercials aimed at youth. But it's not necessary, says the industry, "We can regulate ourselves".

Medical Xpress (EU) - Binge drinking drops, drug use levels off in Europe: report

European teens cut back on binge drinking and showed no increase in illegal drug use in recent years, while cigarettes remained as popular as in 2007, an EU agency said Thursday.

Scotsman (Scotland) - Road safety charity suggests reduced sanctions for drink-drivers

BANS and fines imposed on anyone caught drink-driving should be reduced if the Government lowers the legal alcohol limit, a road safety charity has suggested.

Daily Mail (UK) - Booze cruise is back: Weak euro leads to rush across the Channel to stock up on cheap alcohol

A three-year high for the pound against the euro has seen British bargain hunters return in droves to the booze cruise.

Voxy (Australia) - Alcohol harm drives Maori Party to propose Bill changes

The Maori Party is proposing significant amendments to address alcohol related harm by making changes to the Alcohol Reform Bill including the restrictions around proximity of liquor stores to schools and tightening up the criteria around trading hours.

News Wales (Wales) - Wales drive to combat killer alcohol

Each year 1000 deaths in Wales are due to alcohol and over 40 per cent of the Welsh population report drinking above the current health guidelines.

Forbes (Russia) - Russian Vodka Prices Set to Increase by 30% in July

Starting in July 2012, the minimum price of vodka could go up to 125 rubles ($3.90) for a half liter from the current level of 98 rubles ($3.06). This increase is stipulated in a draft order by Rosalkagolregulirovania (RAR) which the department is planning to publish later this week a source from within RAR told Vedomosti.

Neurosteroid influences on sensitivity to ethanol

This review will highlight a variety of mechanisms by which neurosteroids affect sensitivity to ethanol, including physiological states associated with activity of the hypothalamic–pituitary–adrenal (HPA) and hypothalamic–pituitary–gonadal (HPG) axes, and the effects of chronic exposure to ethanol, in addition to behavioral implications.

To date, γ-aminobutyric acid (GABA_A) receptor mechanisms are a major focus of the modulation of ethanol effects by neuroactive steroids. While NMDA receptor mechanisms are gaining prominence in the literature, these complex data would be best discussed separately.

Accordingly, GABA_A receptor mechanisms are emphasized in this review with brief mention of some NMDA receptor mechanisms to point out contrasting neuroactive steroid pharmacology.

Overall, the data suggest that neurosteroids are virtually ubiquitous modulators of inhibitory neurotransmission. Neurosteroids appear to affect sensitivity to ethanol in specific brain regions and, consequently, specific behavioral tests, possibly related to the efficacy and potency of ethanol to potentiate the release of GABA and increase neurosteroid concentrations.

Although direct interaction of ethanol and neuroactive steroids at common receptor binding sites has been suggested in some studies, this proposition is still controversial. It is currently difficult to assign a specific mechanism by which neuroactive steroids could modulate the effects of ethanol in particular behavioral tasks.

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Mexican immigration to the US and alcohol and drug use opportunities: Does it make a difference in alcohol and/or drug use?

Mexican immigrants in the US do not have increased risk for alcohol use or alcohol use disorders when compared to Mexicans living in Mexico, but they are at higher risk for drug use and drug use disorders. It has been suggested that both availability and social norms are associated with these findings. We aimed to study whether the opportunity for alcohol and drug use, an indirect measure of substance availability, determines differences in first substance use among people of Mexican origin in both the US and Mexico, accounting for gender and age of immigration.

Data come from nationally representative surveys in the United States (2001–2003) and Mexico (2001–2002) (combined n = 3432). We used discrete time proportional hazards event history models to account for time-varying and time-invariant characteristics. The reference group was Mexicans living in Mexico without migration experience.

Female immigrants were at lower risk of having opportunities to use alcohol if they immigrated after the age of 13, but at higher risk if they immigrated prior to this age. Male immigrants showed no differences in opportunity to use alcohol or alcohol use after having the opportunity. Immigration was associated with having drugs opportunities for both sexes, with larger risk among females. Migration was also associated with greater risk of using drugs after having the opportunity, but only significantly for males.

The impacts of immigration on substance use opportunities are more important for drugs than alcohol. Public health messages and educational efforts should heed this distinction.

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Request Reprint E-Mail: guibor@imp.edu.mx

Relationships Among Alcohol Outlet Density, Alcohol use, and Intimate Partner Violence Victimization Among Young Women in the United States

Greater access to alcohol has been widely found to be associated with many negative outcomes including violence perpetration. This study examines the relationship between alcohol outlet density, alcohol use, and intimate partner violence (IPV) victimization among young women in the United States. A direct association between alcohol outlet density in one’s neighborhood and the likelihood of IPV victimization was examined.

Data were from Wave III of the National Longitudinal Study of Adolescent Health (Add Health), which followed a nationally representative sample of adolescents into adulthood. Participants were young adult females age 18 to 26 at Wave III. Of the 4,571 female respondents who reported a current heterosexual relationship and had IPV data, 13.2% reported having been the victim of physical violence only and 6.5% experienced sexual only or physical and sexual violence in the relationship during the past year.

In the regression models tested, there was no significant direct association between neighborhood alcohol outlet density and IPV victimization nor was there an association between outlet density and drinking behaviors, thus eliminating the possibility of an indirect association.

Results of fully adjusted models indicate females who drank heavily, whether infrequently or frequently, were at significant risk for experiencing sexual only IPV or sexual and physical IPV.

Asians and Native Americans were at significantly greater odds of experiencing sexual only or sexual and physical IPV compared with non-Hispanic Whites, while non-Hispanic Blacks were at significantly greater odds for physical only IPV.

We conclude that a continuous measure of alcohol outlet density was not associated with IPV in models controlling for individual and other neighborhood characteristics.

Young women who drink heavily, whether infrequently or frequently, have greater odds of experiencing sexual only or sexual and physical compared to abstainers.

Similar to previous study findings, young women living with or married to their partner were at far greater risk of experiencing physical only and/or sexual only or sexual and physical IPV.

The study adds to the growing body of literature that examines how community characteristics such as outlet density influence the likelihood of IPV.

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Request Reprint E-Mail: mwaller@PIRE.org

Altruism in time: social temporal discounting differentiates smokers from problem drinkers

Recent studies on reinforcer valuation in social situations have informed research on mental illness. Social temporal discounting may be a way to examine effects of social context on the devaluation of delayed reinforcers. In prior research with non-drug-using groups, we demonstrated that individuals discount delayed rewards less rapidly (i.e., value the future more) for a group of which they are a member than they do for themselves alone.

The current study examined how cigarette smoking and level of alcohol use relate to rates of delay and social temporal discounting.

In this study, we used crowd-sourcing technology to contact a large number of individuals (N = 796). Some of these individuals were hazardous-to-harmful drinkers (n = 269), whereas others were non-problem drinkers (n = 523); some were smokers (n = 182), whereas others were nonsmokers (n = 614). Delay discounting questionnaires for individual rewards (me now, me later) and for group rewards (we now, we later; me now, we later) were used to measure individuals’ discounting rates across various social contexts.

Our analyses found that smokers discounted delayed rewards more rapidly than controls under all conditions. However, hazardous-to-harmful drinkers discounted delayed rewards significantly more rapidly than the non-problem drinkers under the individual condition, but not under the social conditions.

This finding suggests that the use of different abused drugs may be associated with excessive discounting in the individual condition and has selective effects when discounting for a group in the social conditions.

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Request Reprint E-Mail: wkbickel@vt.edu.

News Release - Teens and Drinking: A Proposed Law for Overdose Victims

Last month, the New Jersey Assembly approved a new bill, that if passed by the Senate, would guarantee that witnesses who get help for victims of drug and alcohol overdose won’t be prosecuted.

The Rutgers Center of Alcohol Studies has endorsed the bill, known as the “Good Samaritan Overdose Response Act,’’ which center director Robert Pandina believes will save lives. All too often, he says, young people panic when a friend consumes dangerous amounts of drugs or alcohol and fail to get help for fear of reprisals. > > > > Read More

Monday, June 4, 2012

Role of Adrenal Glucocorticoid Signaling in Prefrontal Cortex Gene Expression and Acute Behavioral Responses to Ethanol

Glucocorticoid hormones modulate acute and chronic behavioral and molecular responses to drugs of abuse including psychostimulants and opioids. There is growing evidence that glucocorticoids might also modulate behavioral responses to ethanol (EtOH). Acute EtOH activates the hypothalamic–pituitary–adrenal axis, causing the release of adrenal glucocorticoid hormones. Our prior genomic studies suggest that glucocorticoids play a role in regulating gene expression in the prefrontal cortex (PFC) of DBA2/J (D2) mice following acute EtOH administration. However, few studies have analyzed the role of glucocorticoid signaling in behavioral responses to acute EtOH. Such work could be significant, given the predictive value for the level of response to acute EtOH in the risk for alcoholism.

We studied whether the glucocorticoid receptor (GR) antagonist, RU-486, or adrenalectomy (ADX) altered male D2 mouse behavioral responses to acute (locomotor activation, anxiolysis, or loss-of-righting reflex [LORR]) or repeated (sensitization) EtOH treatment. Whole-genome microarray analysis and bioinformatics approaches were used to identify PFC candidate genes possibly responsible for altered behavioral responses to EtOH following ADX.

ADX and RU-486 both impaired acute EtOH (2 g/kg)-induced locomotor activation in D2 mice without affecting basal locomotor activity. However, neither ADX nor RU-486 altered the initiation of EtOH sensitization (locomotor activation or jump counts), EtOH-induced anxiolysis, or LORR. ADX mice showed microarray gene expression changes in PFC that significantly overlapped with acute EtOH-responsive gene sets derived by our prior microarray studies. Q-rtPCR analysis verified that ADX decreased PFC expression of Fkbp5 while significantly increasing Gpr6 expression. In addition, high-dose RU-486 pretreatment blunted EtOH-induced Fkbp5 expression.

Our studies suggest that EtOH's activation of adrenal glucocorticoid release and subsequent GR activation may partially modulate EtOH's acute locomotor activation in male D2 mice. Furthermore, because adrenal glucocorticoid basal tone regulated PFC gene expression, including a significant set of acute EtOH-responsive genes, this suggests that glucocorticoid-regulated PFC gene expression may be an important factor modulating acute behavioral responses to EtOH.

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Request Reprint E-Mail: mfmiles@vcu.edu

Recent Advances in the Discovery and Preclinical Testing of Novel Compounds for the Prevention and/or Treatment of Alcohol Use Disorders

Alcohol abuse and dependence have a staggering socioeconomic impact, yet current therapeutic strategies are largely inadequate to treat these disorders. Thus, the development of new strategies that can effectively prevent alcohol use disorders (AUDs) is of paramount importance.

Currently approved medications attempt to deter alcohol intake by blocking ethanol metabolism or by targeting the neurochemical systems downstream of the cascades leading to craving and dependence. Unfortunately, these medications have provided only limited success as indicated by the continued high rates of alcohol abuse and alcoholism.

The lack of currently available effective treatment strategies is highlighted by the urgent call by the NIAAA to find new and paradigm-changing therapeutics to either prevent or treat alcohol-related problems.

This mini-review highlights recent findings from 4 laboratories with a focus on compounds that have the potential to be novel therapeutic agents that can be developed for the prevention and/or treatment of AUDs.

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Request Reprint E-Mail: ddavies@usc.edu

The Phosphodiesterase-4 (PDE4) Inhibitor Rolipram Decreases Ethanol Seeking and Consumption in Alcohol-Preferring Fawn-Hooded Rats

Alcohol dependence is a complex psychiatric disorder demanding development of novel pharmacotherapies. Because the cyclic adenosine monophosphate (cAMP) signaling cascade has been implicated in mediating behavioral responses to alcohol, key components in this cascade may serve as potential treatment targets. Phosphodiesterase-4 (PDE4), an enzyme that specifically catalyzes the hydrolysis of cAMP, represents a key point in regulating intracellular cAMP levels. Thus, it was of interest to determine whether PDE4 was involved in the regulation of alcohol use and abuse.

Male Fawn-Hooded (FH/Wjd) rats were tested for 5% (v/v) ethanol (EtOH) and 10% (w/v) sucrose operant oral self-administration following treatment with the selective PDE4 inhibitor rolipram (0.0125, 0.025, or 0.05 mg/kg, subcutaneous [s.c.]); rolipram at higher doses (0.05, 0.1, and 0.2 mg/kg, s.c.) was tested to determine its impact on the intake of EtOH, sucrose, or water using the 2-bottle choice drinking paradigm. Subsequent open-field testing was performed to evaluate the influence of higher doses of rolipram on locomotor activity.

Acute administration of rolipram dose-dependently reduced operant self-administration of 5% EtOH, but had no effect on 10% sucrose responding. Time-course assessment revealed significant decreases in EtOH consumption after rolipram (0.1, 0.2 mg/kg) treatment in continuous- and intermittent access to EtOH at 5% or 10%, respectively. Moreover, chronic rolipram treatment time-dependently decreased 5% EtOH consumption and preference during treatment days and after the termination of rolipram administration. Rolipram at the highest doses (0.1 and 0.2 mg/kg) did decrease locomotor activity, but the effect lasted only 10 and 20 minutes, respectively, which did not likely alter long-term EtOH drinking.

These results suggest that PDE4 plays a role in alcohol seeking and consumption behavior. Drugs interfering with PDE4 may be a potential pharmacotherapy for alcohol dependence.

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Request Reprint E-Mail: hzhang@hsc.wvu.edu

12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment

Adolescents who attend 12-step groups following alcohol and other drug (AOD) treatment are more likely to remain abstinent and to avoid relapse post-treatment. We examined whether 12-step attendance is also associated with a corresponding reduction in health care use and costs.

We used difference-in-difference analysis to compare changes in seven-year follow-up health care use and costs by changes in 12-step participation. Four Kaiser Permanente Northern California AOD treatment programs enrolled 403 adolescents, 13–18-years old, into a longitudinal cohort study upon AOD treatment entry. Participants self-reported 12-step meeting attendance at six-month, one-year, three-year, and five-year follow-up. Outcomes included counts of hospital inpatient days, emergency room (ER) visits, primary care visits, psychiatric visits, AOD treatment costs and total medical care costs.

Each additional 12-step meeting attended was associated with an incremental medical cost reduction of 4.7% during seven-year follow-up. The medical cost offset was largely due to reductions in hospital inpatient days, psychiatric visits, and AOD treatment costs. We estimate total medical use cost savings at $145 per year (in 2010 U.S. dollars) per additional 12-step meeting attended.

The findings suggest that 12-step participation conveys medical cost offsets for youth who undergo AOD treatment. Reduced costs may be related to improved AOD outcomes due to 12-step participation, improved general health due to changes in social network following 12-step participation, or better compliance to both AOD treatment and 12-step meetings.

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Request Reprint E-Mail: marlon.mundt@fammed.wisc.edu

Alcohol Use and STI among men in India: Evidences from a national household survey

Alcohol use has been found to correlate with risky sexual behavior as well as with sexually transmitted infections (STI) among populations with high-risk behavior in India.

To examine the correlates of alcohol use and its association with STI among adult men in India.

Data from a national representative large-scale household sample survey in the country were used. It included information on sociodemographic characteristics and alcohol use as a part of substance use. Clinical as well laboratory testing was done to ascertain the STI.

The overall STI prevalence among adult males was found to be 2.5% (95% confidence interval (CI): 1.9-3.1). Over 26% adult men were found to have been using alcohol in the study population. It was higher among men who were illiterate and unskilled industrial workers/drivers. The men who consumed alcohol had higher prevalence of STI (3.6%; 95% CI: 2.9-5.1) than those who did not consume alcohol (2.1%; 95% CI: 1.5-2.6). The degree of association between alcoholism and STI was slightly reduced after adjusting for various sociodemographic characteristics (adjusted odds ratio: 1.5; 95% CI: 0.9-2.3; P=0.06).

The findings of present study suggest integrating alcohol risk reduction into STI/HIV prevention programmes.

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Request Rerprint E-Mail: arvindpandey@icmr.org.in

Trends and Social Differences in Alcohol Consumption during the Postcommunist Transition in Lithuania

The aim of the study was to evaluate the trends and social differences in consumption of various types of alcoholic beverages in Lithuania over the postcommunist transition period (1994–2010).

The data were obtained from nine nationally representative postal surveys of Lithuanian population aged 20–64 conducted every second year (). Prevalence of regular (at least once a week) consumption of beer, wine, or strong alcoholic beverages and the amount of alcohol consumed per week were examined.

Regular beer drinking as well as the amounts consumed increased considerably in both genders. The increase in regular consumption of strong alcohol was found among women.

Sociodemographic patterning of regular alcohol drinking was more evident in women than in men. In women, young age and high education were associated with frequent regular drinking of wine and beer.

Social differences in regular alcohol drinking should be considered in further development of national alcohol control policy in Lithuania.

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Relationship of Body Mass Index to Alcohol Consumption in College Freshmen

Assess the relationship between body mass index (BMI) and drinking in college freshman.

College freshman (N = 199) at a university completed the drinking questionnaires. Drinking amount and the alcohol problem index (RAPI) served as outcomes, and BMI was the independent variable.

RAPI scores were associated with gender, amount of drinking, and BMI (P < 0.001, F = 13.44). Increase of RAPI with drinking amount was larger for females (slope = 0.06) than for males (slope = 0.03).

This information can be helpful when providing health promotion strategies to college students
regarding nutrition modifications that would be most beneficial for their health.

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News Release - Alcohol May Trigger Serious Palpitations in Heart Patients

The term “holiday heart syndrome” was coined in a 1978 study to describe patients with atrial fibrillation who experienced a common and potentially dangerous form of heart palpitation after excessive drinking, which can be common during the winter holiday season. The symptoms usually went away when the revelers stopped drinking. Now, research from UCSF builds on that finding, establishing a stronger causal link between alcohol consumption and serious palpitations in patients with atrial fibrillation, the most common form of arrhythmia. > > > > Read More

Does change talk during brief motivational interventions with young men predict change in alcohol use?

Client change talk (CT) during motivational interviewing and brief motivational interventions (BMIs) have been described as predictors of behavior change, but these links have not been clearly evaluated in research on young people.

Within 127 BMIs with 20-year-old men with at-risk alcohol consumption, each CT utterance was categorized and given a strength rating using the Motivational Interviewing Skill Code 2.1. Several ways of categorizing and measuring CT were tested using stepwise regression procedures.

Overall CT measures were not significantly related to changes in drinking at 6-month follow-up. Regarding CT sub-dimensions, the frequency of ability/desire/need to change and of ability/desire/need not to change, as well as the average strength of ability/desire/need, predicted significant change in the expected direction. CT length was not significantly linked to outcome.

The frequency and strength with which some CT sub-dimensions are expressed during BMI seemed to be important predictors of change in drinking among young men and might thus be especially important for clinicians to notice.

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Request Reprint E-Mail: Jacques.Gaume@chuv.ch

American teens are less likely than European teens to use cigarettes and alcohol

The U.S. had the second-lowest proportion of students who used tobacco and alcohol compared to their counterparts in 36 European countries, a new report indicates.

The results originate from coordinated school surveys about substance use from more than 100,000 students in some of the largest countries in Europe like Germany, France and Italy, as well as many smaller ones from both Eastern and Western Europe.

Because the methods and measures are largely modeled after the University of Michigan's Monitoring the Future surveys in this country, comparisons are possible between the U.S. and European results. The 15- and 16-year-old students, who were drawn in nationally representative samples in almost all of the 36 countries, were surveyed last spring. American 10th graders in the 2011 Monitoring the Future studies are of the same age, so comparisons are possible.

The differences found between adolescent behaviors in the U.S. and Europe are dramatic, according to Lloyd Johnston, the principal investigator of the American surveys.

About 27 percent of American students drank alcohol during the 30 days prior to the survey. Only Iceland was lower at 17 percent, and the average rate in the 36 European countries was 57 percent, more than twice the rate in the U.S. > > > > Read More

The role of sensation seeking, perceived peer pressure, and harmful alcohol use in riding with an alcohol-impaired driver

Alcohol-related motor vehicle collisions have been the top of policy agenda for more than three decades in Korea. Despite implementation of various traffic safety measures, some drivers’ alcohol use and abuse has resulted in a high number of alcohol-impaired traffic fatalities every year.

This paper presents the association of theoretical factors with behavior of riding with an alcohol-impaired driver (RAID) among all age groups in the Korean adult sample. The theoretical factors of the drivers are personality factor, socio-psychological factor, and alcohol-related behavioral risk factor.

We utilized national survey data from 1007 respondents consisting of 703 males and 304 females aged 20–66 collected by Korean Institute of Criminology (KIC) to test our theorized model.

Our results indicated that there were three major predictors of RAID involvement: sensation seeking propensity, perceived peer pressure, and frequent harmful drinking. Overall, prediction of RAID behavior by gender was mediated entirely through these predictors.

The issue of males’ higher risk of RAID involvements was addressed for effective communication strategies such as campaigns.

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Trends in alcohol-impaired driving in Canada

While a general decreasing trend in the number of persons killed in a traffic crash involving a drinking driver has occurred in Canada since the 1980s, it is evident that much of this decrease occurred in the 1990s. Since 2002, less progress has been made as the number of persons killed in crashes involving drinking drivers remains high.

To better understand the current situation, this paper describes trends in drinking and driving in Canada from 1998 to 2011 using multiple indicators based on data collected for the Traffic Injury Research Foundation's (TIRF) Road Safety Monitor (RSM), the National Opinion Poll on Drinking and Driving, and trends in alcohol-related crashes based on data collected for TIR
F's national Fatality Database in Canada.

There has been a continued and consistent decrease in the number of fatalities involving a drinking driver in Canada. This remains true when looking at the number of fatalities involving a drinking driver per 100,000 population and per 100,000 licensed drivers. This decreasing trend is also still apparent when considering the percentage of persons killed in a traffic crash in Canada involving a drinking driver although less pronounced. Data from the RSM further show that the percentage of those who reported driving after they thought they were over the legal limit has also declined.

However, regardless of the apparent decreasing trend in drinking driving fatalities and behaviour, reductions have been relatively modest, and fatalities in crashes involving drivers who have consumed alcohol remain high at unacceptable levels.

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Drink-driving in community sports clubs: Adopting the Good Sports alcohol management program

Throughout the developed world, community sports clubs are a high-risk setting for alcohol-impaired driving. The Good Sports program accredits community sports clubs to encourage implementation of alcohol-focussed harm-reduction and safe-transport strategies.

This study tested for associations between participation in the Good Sports program and reduced rates of drink-driving amongst club members.

Multilevel modelling indicated that for each season a club was in the program there was an 8% reduction in the odds of drink-driving.

These findings may arise due to clubs with lower rates of alcohol use maintaining longer involvement in the program.

However, the findings are also compatible with the intention of the Good Sports program to reduce the risk that club members will drive whilst alcohol impaired.

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Request Reprint E-Mail: bosco.rowland@deakin.edu.au

Effects of Interactive Voice Response Self-Monitoring on Natural Resolution of Drinking Problems: Utilization and Behavioral Economic Factors

Most problem drinkers do not seek help, and many recover on their own. A randomized controlled trial evaluated whether supportive interactive voice response (IVR) self-monitoring facilitated such "natural" resolutions. Based on behavioral economics, effects on drinking outcomes were hypothesized to vary with drinkers' baseline "time horizons," reflecting preferences among commodities of different value available over different delays and with their IVR utilization.

Recently resolved untreated problem drinkers were randomized to a 24-week IVR self-monitoring program (n = 87) or an assessment-only control condition (n = 98). Baseline interviews assessed outcome predictors including behavioral economic measures of reward preferences (delay discounting, pre-resolution monetary allocation to alcohol vs. savings). Six-month outcomes were categorized as resolved abstinent, resolved nonabstinent, unresolved, or missing. Complier average causal effect (CACE) models examined IVR self-monitoring effects.

IVR self-monitoring compliers (≥70% scheduled calls completed) were older and had greater pre-resolution drinking control and lower discounting than noncompliers (<70%). A CACE model interaction showed that observed compliers in the IVR group with shorter time horizons (expressed by greater pre-resolution spending on alcohol than savings) were more likely to attain moderation than abstinent resolutions compared with predicted compliers in the control group with shorter time horizons and with all noncompliers. Intention-to-treat analytical models revealed no IVR-related effects. More balanced spending on savings versus alcohol predicted moderation in both approaches.

IVR interventions should consider factors affecting IVR utilization and drinking outcomes, including person-specific behavioral economic variables. CACE models provide tools to evaluate interventions involving extended participation.

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Request Reprint E-Mail: jtucker@uab.edu

Do Substance Use Norms and Perceived Drug Availability Mediate Sexual Orientation Differences in Patterns of Substance Use? Results from the Californi

Illicit drug and heavy alcohol use is more common among sexual minorities compared with heterosexuals. This difference has sometimes been attributed to more tolerant substance use norms within the gay community, although evidence is sparse. The current study investigated the role of perceived drug availability and tolerant injunctive norms in mediating the linkage between minority sexual orientation status and higher rates of prior-year substance use.

We used data from the second California Quality of Life Survey (Cal-QOL II), a followback telephone survey in 2008–2009 of individuals first interviewed in the population-based 2007 California Health Interview Survey. The sample comprised 2,671 individuals, oversampled for minority sexual orientation. Respondents were administered a structured interview assessing past-year alcohol and illicit drug use, perceptions of perceived illicit drug availability, and injunctive norms concerning illicit drug and heavier alcohol use. We used structural equation modeling methods to test a mediational model linking sexual orientation and substance use behaviors via perceptions of drug availability and social norms pertaining to substance use.

Compared with heterosexual individuals, sexual minorities reported higher levels of substance use, perceived drug availability, and tolerant social norms. A successfully fitting model suggests that much of the association between minority sexual orientation and substance use is mediated by these sexual orientation–related differences in drug availability perceptions and tolerant norms for substance use.

Social environmental context, including subcultural norms and perceived drug availability, is an important factor influencing substance use among sexual minorities and should be addressed in community interventions.

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Request Reprint E-Mail: cochran@ucla.edu

"To Believe or Not to Believe?" Religiosity, Spirituality, and Alcohol Use Among Hungarian Adolescents

A growing number of studies focus on the relationship between religiosity/spirituality and substance use, including drinking. Although these studies often find a negative association between religiosity and adolescent alcohol use, different religious variables may play an altering role in alcohol-related activities. The primary goal of the present study was to examine the relationship between a set of religious variables (religious denomination, church membership, religious attendance, praying, religiosity, spiritual beliefs, and well-being) and drinking patterns (current alcohol use, lifetime prevalence of drinking, and heavy episodic drinking) among a sample of Hungarian youth.

Data were collected among high school students (N = 592; ages between 14 and 17 years; 48.1% male) from a randomly selected set of schools in Szeged, Hungary, using a self-administered questionnaire and standardized procedures. Student participation was voluntary and confidential.

Despite a high level of alcohol use and a relatively low level of religiosity in the sample, we detected a relationship between the importance of religiousness/religious well-being and alcohol use, although religious denomination and affiliation were not significant correlates. Religious attendance and private praying were associated with lower odds of alcohol use among girls; boys who reported a belief in traditional religion were less likely to engage in alcohol use.

These exploratory results provide further details to a growing body of research showing that despite adolescents' low religious involvement, religiosity can play an important role in some youth's lives and may serve as a protective factor against alcohol use and misuse.

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Relationships Between Local Enforcement, Alcohol Availability, Drinking Norms, and Adolescent Alcohol Use in 50 California Cities

This study investigated relationships between local alcohol policies, enforcement, alcohol outlet density, adult alcohol use, and underage drinking in 50 California cities.

Eight local alcohol policies (e.g., conditional use permit, social host ordinance, window/billboard advertising) were rated for each city based on their comprehensiveness. Local alcohol enforcement was based on grants received from the California Alcoholic Beverage Control agency for enforcement of underage drinking laws. Outlet density was based on the number of on- and off-premise outlets per roadway mile. Level of adult alcohol use was ascertained from a survey of 8,553 adults and underage drinking (frequency of past-year alcohol use and heavy drinking) from surveys of 1,312 adolescents in 2009 and 2010. Multilevel regression analyses were conducted to examine the effects of policies, enforcement, and other community-level variables on adolescent drinking, controlling for youth demographic characteristics. Mediating effects of adolescents' perceived ease of obtaining alcohol, perceived enforcement, and perceived acceptability of alcohol use also were examined.

None of the eight local alcohol-policy ratings were associated with adolescent drinking. Funding for underage drinking enforcement activities was inversely related to frequency of past-year alcohol use, whereas outlet density and adult drinking were positively related to both past-year alcohol use and heavy drinking. These relationships were attenuated when controlling for perceived ease of obtaining alcohol, enforcement, and acceptability of alcohol use, providing evidence for mediation.

Adolescent alcohol use and heavy drinking appear to be influenced by enforcement of underage drinking laws, alcohol outlet density, and adult alcohol use. These community-level influences may be at least partially mediated through adolescents' perceptions of alcohol availability, acceptability of alcohol use, and perceived likelihood of getting in trouble with local police.

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Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disord

Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment.

We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs).

In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment.

Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment.

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Aims

Friday, June 8, 2012

Tuesday, June 5, 2012

Monday, June 4, 2012