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

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


Saturday, June 23, 2012

Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students

There has been a dramatic rise in the consumption of alcohol mixed with energy drinks (AmEDs) in social drinkers. It has been suggested that AmED beverages might lead individuals to drink greater quantities of alcohol. This experiment was designed to investigate whether the consumption of AmEDs would alter alcohol priming (i.e., increasing ratings of wanting another drink) compared with alcohol alone.

Participants (n = 80) of equal gender attended 1 session where they were randomly assigned to receive 1 of 4 doses (0.91 ml/kg vodka, 1.82 ml/kg energy drink, 0.91 ml/kg vodka mixed with 1.82 ml/kg energy drink [AmED], or a placebo beverage). Alcohol-induced priming of the motivation to drink was assessed by self-reported ratings on the Desire for Drug questionnaire.

The priming dose of alcohol increased the subjective ratings of “desire” for more alcohol, consistent with previous research that small doses of alcohol can increase the motivation to drink. Furthermore, higher desire ratings over time were observed with AmEDs compared with alcohol alone. Finally, ratings of liking the drink were similar for the alcohol and AmED conditions.

An energy drink may elicit increased alcohol priming. This study provides laboratory evidence that AmED beverages may lead to greater motivation to drink versus the same amount of alcohol consumed alone.

Read Full Abstract

Request Reprint E-Mail:

Boat Safe. Boat Sober.

What is one of the leading contributing factors in fatal boating accidents? Alcohol. Just like being behind the wheel of a vehicle while intoxicated, the consequences of boating under the influence are deadly.

Alcohol can impair vision, coordination, balance and judgment. All of these impairments are further magnified by being on the water; when impaired by alcohol, boating accidents are more likely and more deadly for both passengers and boat operators. Sun, wind, noise, vibration and motion – stressors common to the boating environment – intensify the side effects of alcohol and drugs on the water.

Each state has laws prohibiting operation of a vessel while under the influence of alcohol or drugs. The Coast Guard also enforces a federal law prohibiting boating under the influence. Operating a recreational vessel with a blood alcohol content of .08 or higher is against federal law. The blood alcohol content is .04 or higher if you are aboard a commercial vessel.

This weekend, June 22 through 24, a multi-agency initiative is taking to the water in an effort to limit accidents and fatalities as a result of boating under the influence and educate boaters across the nation on just how dangerous it is to mix boating and alcohol.

Operation Dry Water puts thousands of local, state and federal law enforcement officers on the water nationwide to keep a lookout for boaters who drink as well as providing boating safety education and awareness materials. > > > > Read More

Effect of intermittent exposure to ethanol and MDMA during adolescence on learning and memory in adult mice

Heavy binge drinking is increasingly frequent among adolescents, and consumption of 3,4-methylenedioxymethamphetamine (MDMA) is often combined with ethanol (EtOH). The long-lasting effects of intermittent exposure to EtOH and MDMA during adolescence on learning and memory were evaluated in adult mice using the Hebb-Williams maze.

Adolescent OF1 mice were exposed to EtOH (1.25 g/kg) on two consecutive days at 48-h intervals over a 14-day period (from PD 29 to 42). MDMA (10 or 20 mg/kg) was injected twice daily at 4-h intervals over two consecutive days, and this schedule was repeated six days later (PD 33, 34, 41 and 42), resulting in a total of eight injections. Animals were initiated in the Hebb-Williams maze on PND 64. The concentration of brain monoamines in the striatum and hippocampus was then measured.

At the doses employed, both EtOH and MDMA, administered alone or together, impaired learning in the Hebb-Williams maze, as treated animals required more time to reach the goal than their saline-treated counterparts. The groups treated during adolescence with EtOH, alone or plus MDMA, also presented longer latency scores and needed more trials to reach the acquisition criterion score. MDMA induced a decrease in striatal DA concentration, an effect that was augmented by the co-administration of EtOH. All the treatment groups displayed an imbalance in the interaction DA/serotonin.

The present findings indicate that the developing brain is highly vulnerable to the damaging effects of EtOH and/or MDMA, since mice receiving these drugs in a binge pattern during adolescence exhibit impaired learning and memory in adulthood.

Read Full Article (PDF)

Friday, June 22, 2012

Alcohol Consumption and Dietary Patterns: The FinDrink Study

The aim of this population-based study was to investigate differences in dietary patterns in relation to the level of alcohol consumption among Finnish adults.

This study was part of the FinDrink project, an epidemiologic study on alcohol use
among Finnish population. It utilized data from the Kuopio Ischaemic Heart Disease Risk Factor Study.

A total of 1720
subjects comprising of 816 men and 904 women aged 53–73 years were included in the study in 1998–2001. Food intake was collected via a 4-day food diary method. Self-reported alcohol consumption was assessed with quantity-frequency method based on the Nordic Alcohol Consumption Inventory. Weekly alcohol consumption was categorized into three
groups: non-drinkers (,12 grams), moderate drinkers (12–167.9 grams for men, 12–83.9 grams for women) and heavy drinkers ($168 grams for men, $84 grams for women). Data were analyzed for men and women separately using multiple linear regression models, adjusted for age, occupational status, marital status, smoking, body mass index and leisure time physical activity.

In women, moderate/heavy drinkers had lower fibre intake and moderate drinkers had higher vitamin D
intake than non-drinkers. Male heavy drinkers had lower fibre, retinol, calcium and iron intake, and moderate/heavy drinkers had higher vitamin D intake than non-drinkers. Fish intake was higher among women moderate drinkers and men moderate/heavy drinkers than non-drinkers. In men, moderate drinkers had lower fruit intake and heavy drinkers had lower milk intake than non-drinkers. Moderate drinkers had higher energy intake from total fats and monosaturated fatty acids than non-drinkers. In contrast, energy intake from carbohydrates was lower among moderate/heavy drinkers than nondrinkers.

In conclusion, especially male heavy drinkers had less favorable nutritional intake than moderate and non-drinkers. Further studies on the relationship between alcohol consumption and dietary habits are needed to plan a comprehensive dietary intervention programs in future.

Read Full Article (PDF)

NTA consultation on introduction of alcohol outcome measures into NDTMS; DH Update on Public Health Funding

NTA consultation on alcohol treatment outcome measures

The National Treatment Agency (NTA) has opened a consultation for a three month period on the introduction of outcome measures into the National Drug Treatment Monitoring System (NDTMS) alcohol dataset.

The proposed outcome measures are outlined in this consultation document which explores 10 specific questions relating to developing outcome recording. The questions seek views on key outcome indicators including consumption, physical and mental health, housing status and other measures.

The deadline for responses is 20th September 2012. Existing national alcohol treatment data can be seen here, and details on the Payment by Results pilots here. > > > > Read More

Public Listing of Comments on Request for Information (RFI): Input into the Scientific Strategic Plan for the proposed National Institute of Substance

Thank you to everyone who responded to the Request for Information on the Scientific Strategic Plan for the proposed Institute on substance use, abuse, and addiction. The comments are now online and can be viewed here. We are currently reviewing these comments and will provide a complete analysis in August.

Remission from alcohol and other drug problem use in public and private treatment samples over seven years

The treatment of alcohol and other drugs is now more commonly framed in terms of a chronic condition which requires ongoing monitoring. A model which includes continuing access to health care may optimize outcomes. Most studies of chronic care models have not included health care and have only examined short term effects.

The sample (n = 783) included consecutive admissions in ten public and private alcohol and other drug (AOD) treatment programs followed over seven years. The outcome was remission which was defined as alcohol and drug abstinence or non-problem use.

In the private sample, receiving health care services predicted remission across the seven years; however this did not occur in the public sample. More patients in the public treatment sample received AOD treatment readmissions each year, while more of those in the private sector received psychiatric and general health visits. Except for drug problem severity, there were no other clinical differences between the samples. There were no differences in the proportions of patients in the two sectors who received the full spectrum of chronic care services. In the final models, 12-step participation was markedly significant for both samples.

Models of chronic care for substance use need to consider differences between private and public treatment and should take into account that individuals may not always have access, or avail themselves of services that may optimize long-term outcomes.

Read Full Abstract

Request Reprint E-Mail:

Thursday, June 21, 2012

Interactions among positions in the third and fourth Membrane-associated domains at the intersubunit interface mf the N-Methyl-D-Aspartate Receptor Fo

The N-methyl-D-aspartate (NMDA) glutamate receptor is a major target of ethanol in the brain. Previous studies have identified positions in the third and fourth membrane-associated (M) domains of the NMDA receptor GluN1 and GluN2A subunits that influence alcohol sensitivity. The predicted structure of the NMDA receptor, based on that of the related GluA2 subunit, indicates a close apposition of the alcohol-sensitive positions in M3 and M4 between the two subunit types.

We tested the hypothesis that these positions interact to regulate receptor kinetics and ethanol sensitivity by using dual substitution mutants.

In single-substitution mutants, we found that a position in both subunits adjacent to one previously identified, GluN1(Gly638) and GluN2A(Phe636), can strongly regulate ethanol sensitivity.

Significant interactions affecting ethanol inhibition and receptor deactivation were observed at four pairs of positions in GluN1/GluN2A: Gly638/Met823, Phe639/Leu824, Met818/Phe636, and Leu819/Phe637; the latter pair also interacted with respect to desensitization.

Two interactions involved a position in M4 of both subunits, GluN1(Met818) and GluN2A(Leu824), that does not by itself alter ethanol sensitivity, whereas a previously identified ethanol-sensitive position, GluN2A(Ala825), did not unequivocally interact with any other position tested.

These results also indicate a shift by one position of the predicted alignment of the GluN1 M4 domain.

These findings have allowed for the refinement of the NMDA receptor M domain structure, demonstrate that this region can influence apparent agonist affinity, and support the existence of four sites of alcohol action on the NMDA receptor each consisting of five amino acids at the M3-M4 domain intersubunit interfaces.

Read Full Article (PDF)

Can harms associated with high-intensity drinking be reduced by increasing the price of alcohol?

Increasing the price of alcohol is consistently shown to reduce the average level of consumption. However, the evidence for the effect of increasing the price on high-intensity drinking is both limited and equivocal. The aim of this analysis is to estimate the effect of changes in price on patterns of consumption.

Self-reported patterns of alcohol consumption and demographic data were obtained from the Australian National Drug Strategy Household Surveys, conducted in 2001, 2004 and 2007. A pooled three-stage least-squares estimator was used to simultaneously model the impact of the price on the frequency (measured in days) of consuming no, low, moderate and high quantities of alcohol.

A 1% increase in the price of alcohol was associated with a statistically significant increase of 6.41 days per year on which no alcohol is consumed (P 0.049), and a statistically significant decrease of 7.30 days on which 1–4 standard drinks are consumed (P 0.021). There was no statistically significant change for high or moderate-intensity drinking.

For Australia, and countries with a similar pattern of predominant high-intensity drinking, taxation policies that increase the price of alcohol and are very efficient at decreasing harms associated with reduced average consumption may be relatively inefficient at decreasing alcohol harms associated with high-intensity drinking.

Read Full Abstract

Request Reprint E-Mail:

Sex differences in how a low sensitivity to alcohol relates to later heavy drinking

A low level of response (LR), or low sensitivity, to alcohol is a genetically influenced characteristic that predicts future heavy drinking and alcohol problems. While previous analyses of how LR relates to heavier drinking reported the process is similar in males and females, some potential sex differences have been identified. This difference is further explored in these analyses.

Prospective structural equation models (SEMs) were evaluated for 183 young adult females and 162 males, none of Asian background, from the Collaborative Study on the Genetics of Alcoholism. Invariance analyses and SEM evaluations by sex were used to compare across females and males for these primarily Caucasian (75%), non-Asian young (mean age 19) subjects.

The prospective SEM for the full set of 345 subjects had good fit characteristics and explained 37% of the variance. While the initial invariance analyses identified few sex differences, comparisons of correlations and direct evaluations of path coefficients across males and females indicated that only females showed a link between a low LR and future alcohol problems that was partially mediated by more positive alcohol expectancies and drinking to cope. These sex differences were reflected in the different structures of the SEM results for female versus male subjects.

These prospective results indicate that there might be some important sex differences regarding how a lower LR relates to alcohol outcomes that should be considered in protocols focusing on preventing the impact of LR on future drinking problems.

Read Full Abstract

Request Reprint E-Mail:

Role of non-coding RNAs in the neuroadaptation to alcoholism and fetal alcohol exposure

The control of gene expression is a fundamental process in all of biology. Understanding the mechanisms by which genes are turned off and on in a temporally and spatially mediated fashion, represents an area where major scientific advances are likely to occur in the next decade. This is because the control of the timing and location of gene expression is arguably one of the most critical regulation points in determining cellular identity and function and when gene regulation is perturbed disease states can arise. Classic gene expression control mechanisms such as cis-acting elements in gene promoters and trans-acting factors (transcription factor proteins) have been well studied. However, the recent discovery of gene expression regulation mediated by RNA molecules that are transcribed from DNA but do not code for protein, has set into motion a revolution in molecular biology. These novel RNAs are classified broadly as non-coding RNAs (ncRNAs) and include both small (microRNAs or miRNAs) and large classes (long non-coding RNAs or lncRNAs) that function to alter the expression of genes to which they bind and modify chromatin states. Yet, there remains much to be understood about the biology of ncRNAs and how this contributes to susceptibility to disease.

Like all complex traits, alcoholism is influenced by multiple genetic and environmental factors. In addition, there is significant heterogeneity found with alcoholism making it a daunting task to identify the specific genes associated with the disease. Although progress has been made in identifying some of the genetic variants, explaining the entire phenotypic variation associated with alcoholism is far from complete. Most of the recent efforts in understanding the genetic vulnerability to alcoholism have focused on genotype-phenotype associations. For example, in the last several years there has been an explosion in Genome-Wide Association Studies (GWAS), which seek to correlate common genetic variation (represented by Single Nucleotide Polymorphisms or SNPs) with a particular trait or disease. Success of GWAS has varied across different complex traits, where most studies have found that individual SNPs account for a very small proportion of the variance. This is true for GWAS studies of alcoholism and alcohol-related phenotypes, where genome-wide significance has rarely been achieved. There are several prevailing hypotheses that have been put forth to explain the small effect sizes observed with GWAS and other approaches. These include arguments for the contribution of untested rare variants, sample power issues, and “phantom heritability.” It is clear, however, that new perspectives for understanding genetic vulnerability to alcoholism are warranted, and the burgeoning area of microRNAs appears to be a fruitful area of investigation. This is because determining the role of microRNAs in disease will offer both mechanistic and potential therapeutic insight. > > > > Read More

Temporal Associations of Popularity and Alcohol Use Among Middle School Students

The goal of this study is to better understand the longitudinal cross-lagged associations between popularity, assessed through self-rating and peer nominations, and alcohol use among middle school students.

The analytical sample comprises 1,835 sixth- to eighth-grade students who were initially recruited from three California middle schools and surveyed in the fall and spring semesters of 2 academic years. Students reported on their background characteristics, past-month alcohol use, and perceived popularity. Additionally, students provided school-based friendship nominations, which were used to calculate peer-nominated popularity. A cross-lagged regression approach within a structural equation modeling framework was used to examine the longitudinal relationship between popularity (self-rated and peer-nominated) and alcohol use.

There was a statistically significant (p = .024) association between peer-nominated popularity and the probability of alcohol consumption at the subsequent survey, but not vice versa. Our results suggest that in a scenario where 8% of students are past-month drinkers, each increase of five friendship nominations is associated with a 30% greater risk of being a current drinker at the next wave. We found no evidence of longitudinal associations between past-month alcohol consumption and self-rated popularity.

Popularity is a risk factor for drinking during the middle school years, with peer-nominated popularity being more predictive of use than self-perceptions of popularity. To inform alcohol prevention efforts for middle school students, additional research is needed to better understand why adolescents with a larger number of school-based friendship ties are more inclined to drink.

Read Full Abstract

Request Reprint E-Mail:

Latest from the IBA blog: When to do extended brief interventions; young people's IBA resources; is self-completing AUDIT OK? & more

A selection of recent posts from the IBA blog, a resource promoting news, links and ideas relating to alcohol brief interventions are included below:

Effect of intermittent exposure to ethanol and MDMA during adolescence on learning and memory in adult mice

Heavy binge drinking is increasingly frequent among adolescents, and consumption of 3,4-methylenedioxymethamphetamine (MDMA) is often combined with ethanol (EtOH). The long-lasting effects of intermittent exposure to EtOH and MDMA during adolescence on learning and memory were evaluated in adult mice using the Hebb-Williams maze.

Adolescent OF1 mice were exposed to EtOH (1.25 g/kg) on two consecutive days at 48-h intervals over a 14-day period (from PD 29 to 42). MDMA (10 or 20 mg/kg) was injected twice daily at 4-h intervals over two consecutive days, and this schedule was repeated six days later (PD 33, 34, 41 and 42), resulting in a total of eight injections. Animals were initiated in the Hebb-Williams maze on PND 64. The concentration of brain monoamines in the striatum and hippocampus was then measured.

At the doses employed, both EtOH and MDMA, administered alone or together, impaired learning in the Hebb-Williams maze, as treated animals required more time to reach the goal than their saline-treated counterparts. The groups treated during adolescence with EtOH, alone or plus MDMA, also presented longer latency scores and needed more trials to reach the acquisition criterion score. MDMA induced a decrease in striatal DA concentration, an effect that was augmented by the co-administration of EtOH. All the treatment groups displayed an imbalance in the interaction DA/serotonin.

The present findings indicate that the developing brain is highly vulnerable to the damaging effects of EtOH and/or MDMA, since mice receiving these drugs in a binge pattern during adolescence exhibit impaired learning and memory in adulthood.

Read Full Article (PDF)

Wednesday, June 20, 2012

The relationship between naloxone-induced cortisol and mu opioid receptor availability in mesolimbic structures is disrupted in alcohol dependent subj

The mu opioid receptor system is altered in alcohol dependent (AD) subjects. Cortisol responses to opioid receptor antagonists are assumed to impart information about opioid receptor activity. In the present study we examined naloxone-induced cortisol responses in 18 healthy control (HC) and 25 recently detoxified AD subjects and then correlated the cortisol response with mu opioid receptor availability across 15 brain regions using positron emission tomography (PET) and the mu opioid receptor selective ligand [11C] Carfentanil (CFN).

On average the AD subjects required twice the dose of naloxone to induce a peak cortisol response compared to the HC subjects.

Using the rising slope of the cortisol curve (placebo to peak) as a metric we then went on to examine the relationship between cortisol responses to naloxone and [

There were significant negative relationships between cortisol and [
11C]CFN binding potential (BPND) in multiple brain regions of HC subjects. However, cortisol responses did not correlate with [11C]CFN BPND across any brain region in AD subjects.

In summary, naloxone imparts information about individual differences in mu opioid receptor availability throughout the mesolimbic system in healthy individuals. However pathways governing the relationship between naloxone-induced cortisol and mu opioid receptor availability are disrupted during early abstinence in AD subjects.

Read Full Abstract

Request Reprint E-Mail:

Intermittent Availability of Ethanol Does Not Always Lead to Elevated Drinking in Mice

Intermittent access (IA) to an alcohol (ethanol) solution can lead rats to higher ethanol intakes than continuous access, and a recent report showed increased drinking in C57BL/6J mice offered 20% ethanol vs. water 3X/week (Prior studies have offered ethanol during 24 h periods, either continuously or intermittently.).

We tested the high-preference C57BL/6J inbred mice: we also studied High Drinking in the Dark (HDID) mice, a line we have selectively bred to reach intoxicating blood ethanol levels after a short period of access to a single bottle of 20% ethanol.

Neither HDID or C57BL/6J male mice offered ethanol every other day during only a 4-h access period showed greater daily intake than mice offered ethanol daily for 4 h. There was a small increase in drinking with 24 h IA in C57BL/6J mice. An experiment with HDID mice and their control heterogeneous stock stock modeled closely after a published study with C57BL/6J mice (Hwa, Chu, Levinson SA et al. Persistent escalation of alcohol drinking in C57BL/6J mice with intermittent access to 20% ethanol. Alcohol Clin Exp Res 2011;35:1938–1947) showed no significant elevation with 24 h IA exposure in either sex of any genotype. Finally, a near replication of the Hwa et al. study showed modestly greater intake in C57BL/6J mice, confirming the efficacy of 24 h IA.

We conclude that 4 h of IA is likely insufficient to elevate drinking in mice. The lack of effect in HDID mice and their controls further suggests that not all genotypes respond to intermittency.

Read Full Abstract

Request Reprint E-Mail:

Global Actions June 20, 2012

Key Recent Milestones:

· Vietnam: Global Actions is supporting actions by Pernod Ricard which aim to address harmful drinking amongst university students. The new responsible drinking campaign was launched in June with an event at the University of Transport and Communications in Hanoi.

Global Actions in Focus: Global Actions Conference

Plans are progressing for the upcoming conference “Global Actions: Initiatives to Reduce Harmful Drinking” to be held in Washington, D.C. from October 8 and 9, 2012. The first of its kind globally, the international conference aims to raise awareness about industry’s work in support of the WHO Global Strategy to Reduce the Harmful Use of Alcohol.

Chief Executives from ICAP sponsor companies, including Brown Forman’s Paul Varga and ABInBev’s Carlos Brito, are scheduled as keynote speakers at the opening session offering their perspectives on the role industry plays in reducing harmful drinking. President of the Responsible Retailing Forum Dr. Brad Krevor will offer insights on the contribution retailers and sellers make in ensuring responsible drinking. Communications and programs supported by industry which aim at engaging consumers about responsible drinking will be presented by Diageo’s Director of Corporate Social Responsibility Carolyn Panzer.

Day One will proceed with interactive break out discussions continued from the morning plenary presentations featuring experts, researchers and case studies from around the world. Also that same afternoon, ICAP Senior Vice President Brett Bivans will lead the discussion on the importance of data exchange to shape policy and programs, LTG Associates’ Dr. Alberto Bouroncle will chair a discussion of the essential role monitoring and evaluation plays in targeting initiatives, and ICAP Deputy President Dr. Marjana Martinic will facilitate inputs from experts on competing interests.

The second day of the conference will focus on industry commitments to Global Actions and review the past two and a half years of initiatives with participation from partners in the 27 Global Actions countries. Global Alcohol Producers Group Director General Mark Leverton will present an overview of Global Actions work. Breakout sessions are set to follow in the areas of noncommercial alcohol, self-regulation, drink drive, and education in Africa, Asia, Europe, and Latin America. Channel Research’s Emery Brusset will present a summary of findings from an evaluation of the Global Actions initiatives.

Pernod Ricard CEO Pierre Pringuet is scheduled to speak at the closing of the conference and share his vision on future industry commitment to reducing harmful drinking. Visit the conference website for updates to the agenda and to register to attend.

What’s Happening Next:

· Brazil: The Rio+20 United Nations Conference on Sustainable Development is being held June 20 to 22 in Rio de Janeiro. The Conference will mark the 20th anniversary of the 1992 United Nations Conference on Environment and Development.

Risky Messages in Alcohol Advertising, 2003–2007: Results From Content Analysis

To assess the content of alcohol advertising in youth-oriented U.S. magazines, with specific attention to subject matter pertaining to risk and sexual connotations and to youth exposure to these ads.

This study consisted of a content analysis of a census of 1,261 unique alcohol advertisements (“creatives”) recurring 2,638 times (“occurrences”) in 11 U.S. magazines with disproportionately youthful readerships between 2003 and 2007. Advertisements were assessed for content relevant to injury, overconsumption, addiction, and violations of industry guidelines (termed “risk” codes), as well as for sexism and sexual activity.

During the 5-year study period, more than one-quarter of occurrences contained content pertaining to risk, sexism, or sexual activity. Problematic content was concentrated in a minority of brands, mainly beer and spirits brands. Those brands with higher youth-to-adult viewership ratios were significantly more likely to have a higher percentage of occurrences with addiction content and violations of industry guidelines. Ads with violations of industry guidelines were more likely to be found in magazines with higher youth readerships.

The prevalence of problematic content in magazine alcohol advertisements is concentrated in advertising for beer and spirits brands, and violations of industry guidelines and addiction content appear to increase with the size of youth readerships, suggesting that individuals aged <21 years may be more likely to see such problematic content than adults.

Read Full Abstract

Request Reprint E-Mail:

An international legal strategy for alcohol control: not a framework convention—at least not yet

The perceived success of the Framework Convention on Tobacco Control (FCTC) in influencing national and global public health policies has led to growing interest in promulgating new international legal instruments to address global health issues—including calls for a Framework Convention on Alcohol Control (FCAC).

Despite broad support in the public health community, the authors caution that an analysis of the value of lawmaking for alcohol control cannot rest solely on the character of the underlying public health challenge and the similarities between alcohol control and tobacco control. Other factors must be considered, including the relative political feasibility for global health lawmaking. The potential contribution of non-binding international legal instruments to advancing global alcohol control, in particular, deserves strong consideration.

The authors propose a gradual international legal strategy for alcohol control, starting with a non-binding code of practice focusing on areas of critical concern with wide political consensus, leading over time to a comprehensive binding treaty. Although often dismissed as ineffective relative to treaties, non-binding international legal instruments have particular strengths and can create both norms and processes that impact the behavior of states and other actors, overcoming a number of limitations of more rigid legally binding strategies.

Ultimately, the authors contend that the negotiation and adoption of a non-binding international legal instrument as a first step in a long-run legal strategy offers a more politically realistic, and potentially superior, alternative to immediate efforts to achieve a Framework Convention on Alcohol Control.

Read Full Abstract

Request Reprint E-Mail:

News Release - Danish studies suggest low and moderate drinking in early pregnancy has no adverse effects on children aged five

Low and moderate weekly alcohol consumption in early pregnancy is not associated with adverse neuropsychological effects in children aged five, suggests a series of papers published today in BJOG. However, high levels of alcohol per week were linked with a lower attention span among five year olds.

The Danish researchers have produced five papers looking at the effects of low, moderate, high and binge drinking on five year olds. Women were recruited from the Danish National Birth Cohort at their first antenatal visit.

Low average weekly alcohol consumption was defined as 1-4 drinks per week, moderate as 5-8 drinks per week and high levels as 9 or more drinks per week. Binge drinking was defined as intake of 5 or more drinks on a single occasion. Participants who did not drink during pregnancy were included as the unexposed reference group. > > > > Read More

Tuesday, June 19, 2012

Scotland reports and news: latest hospital statistics, drink drive limit to be lowered; alcohol retail and pricing reports

Alcohol Related Hospital Statistics 2012

Scotland's Information Services Division (ISD) has published alcohol-related hospital discharge statistics in the latest Alcohol-related Hospital Statistics report (full pdf report here). Key findings include:

  • In 2010/11, there were 38,825 alcohol-related discharges from a general acute hospital in Scotland (a rate of 695 discharges per 100,000 population).
  • In 2010/11, the rate of alcohol-related discharges from general acute hospitals was 7.6 times greater from patients living in the most deprived areas (category 1), compared to those living in the least deprived areas (category 5).
  • Rates of alcohol-related discharge were highest in the 50 to 54 years age group with a rate of 1,319 discharges per 100,000 population.
  • The rate of alcohol-related discharges from a general acute hospital decreased by over 2% between 2009/10 and 2010/11.
  • Alcohol dependence was recorded in 69% (2,807) of all alcohol-related discharges from psychiatric hospitals

Statistics for England can be found here.

Scottish Drink Drive limit to be lowered

The drink-drive limit in Scotland will be lowered "as a priority", according to the BBC. Justice Secretary Kenny MacAskill said plans to lower the limit from 80mg of alcohol per 100ml of blood to 50mg will be brought forward later this year. Doctors welcomed plans according to The Herald.

Last year in England the Government decided to keep the 80mg legal limit despite a report advising it to be lowered in line with most of Europe.

Retail sales data and discount ban impact reports

Two reports have been recently released as part of the Monitoring and Evaluating Scotland’s Alcohol Strategy:

Scotland's Alcohol Minimum Pricing Bill was passed last month, meaning a 50 pence minimum unit price (MUP) could be in place north of the border by April next year. > > > > Read More

State Laws to Reduce the Impact of Alcohol Marketing on Youth: Current Status and Model Policies

The alcohol industry spends more than $4 billion each year marketing its products. Underage youth receive substantial exposure to this marketing, and multiple longitudinal studies have correlated this exposure with greater likelihood of drinking, or if young people have already initiated alcohol use, drinking more. Reducing the impact of alcohol marketing on young people is an important public health goal since underage drinking is a significant contributor to youth alcohol-related motor vehicle crashes and other forms of injury, violence, suicide, and problems associated with school and family.

State public health departments in California, Massachusetts, and Florida have made crucial strides in reducing underage smoking rates in their states by sponsoring tobacco counter-advertising campaigns.Research indicates that this approach should also be used as part of a comprehensive public health strategy to reduce underage drinking. However, in the case of alcohol, few experiments in counter-advertising have been carried out. Alcohol-specific media literacy is another strategy that has shown promise, but it is expensive to implement and has not been tested on a broad scale.

The appeal of alcohol to underage youth can also be limited by reducing youth exposure to alcohol advertising and marketing. The Federal Trade Commission has issued a series of reports on the topic and has encouraged voluntary action on the part of the alcohol industry. In response, alcohol marketers have made some limited reforms in their voluntary codes. However, these revisions fall far short of recommendations from the National Academy of Sciences, state attorneys general, and other scientific and advocacy organizations. In the last decade, while youth exposure to alcohol advertising has declined in magazines, it has increased substantially on television, growing at a pace faster than the exposure of adults age 21 and above and young adults ages 21 to 34.

Alcohol advertising regulation can apply to measured and unmeasured media. Measured media encompass traditional forms of advertising—electronic media (radio and television), outdoor billboards and signs, and print (magazines and newspapers). Regulation of these media can be directed at either the advertisement’s content or its placement. Content regulation addresses which images and statements the ad can carry, and placement regulation addresses where the ad can be shown to the public.

Unmeasured media include nontraditional venues for promoting a product: Internet marketing, consumer contests, prizes, giveaways, product placement in movies and television shows, novelties and other consumer items (e.g., logos on T-shirts), and sponsorships of concerts, sporting events, and other forms of entertainment and celebrations. These marketing venues and strategies are part of a dramatic shift in advertising strategy, termed branding, where the advertiser establishes an emotional connection between the brand and the targeted audience. The brand becomes embedded in the audience’s experience, cultural icons, and values. Content and placement therefore merge, and, to be effective, regulation must address both variables concurrently. The alcohol industry’s increasing reliance on unmeasured media strategies reflects a general trend within the consumer products and marketing industries and creates new challenges for regulators and public health advocates, particularly given the appeal of new media to youth.

Read Full Report (PDF)

Monday, June 18, 2012

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns and both initiation and development of adolescent alcohol use.

Longitudinal data (four annual measurements) of parent–child dyads (N = 2,319) have been used. Parental drinking patterns have been identified using latent class analysis. The associations of parental drinking patterns and the initiation and development of 12–15 year olds' drinking have been examined with latent growth curve modeling.

Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking.

When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant.

Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES.

Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts initiation and development of alcohol consumption in their offspring.

Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly in adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.

Read Full Abstract

Request Reprint E-Mail:

Trait-based affective processes in alcohol-involved risk behaviors

This study tested a theoretical model of alcohol use, markers of extreme intoxication, and risk behavior as a function of trait affect, distress tolerance, and affect-based behavior dysregulation. Positive affective pathways to risk behavior were primarily expected to be indirect via high levels of alcohol use, while negative affect paths were expected to be more directly associated with engagement in risk behavior. In addition, we expected trait affectivity and distress tolerance would primarily exhibit relationships with alcohol use and problems through behavioral dysregulation occurring during extreme affective states.

To evaluate these hypotheses, we tested a SEM with three alcohol–related outcomes: “Typical” alcohol use, “blackout” drinking,” and risk behavior.

Results were complex, but generally supported the hypotheses. High trait negative affect and low tolerance for affective distress contribute to difficulty controlling behavior when negatively aroused and this is directly associated with increased risk behavior when drinking. In contrast, associations between positive urgency and risk behaviors are indirect via increased alcohol consumption. Positive affectivity exhibited both inverse and positive effects in the model, with the net effect on alcohol outcomes being insignificant.

These findings contribute important information about the distinct pathways between affect, alcohol use, and alcohol-involved risk behavior among college students.

Read Full Abstract

Request Reprint E-Mail:

Craving as a Predictor of Treatment Outcomes in Heavy Drinkers with Comorbid Depressed Mood

Alcohol and depression comorbidity is high and is associated with poorer outcomes following treatment. The ability to predict likely treatment response would be advantageous for treatment planning. Craving has been widely studied as a potential predictor, but has performed inconsistently. The effect of comorbid depression on craving's predictive performance however, has been largely neglected, despite demonstrated associations between negative affect and craving.

The current study examined the performance of craving, measured pre-treatment using the Obsessive subscale of the Obsessive Compulsive Drinking Scale, in predicting 18-week and 12-month post-treatment alcohol use outcomes in a sample of depressed drinkers.

Data for the current study were collected during a randomized controlled trial (Baker, Kavanagh, Kay-Lambkin, Hunt, Lewin, Carr, & Connolly, 2010) comparing treatments for comorbid alcohol and depression. A subset of 260 participants from that trial with a Timeline Followback measure of alcohol consumption were analyzed.

Pre-treatment craving was a significant predictor of average weekly alcohol consumption at 18 weeks and of frequency of alcohol binges at 18 weeks and 12 months, but pre-treatment depressive mood was not predictive, and effects of Baseline craving were independent of depressive mood.

Results suggest a greater ongoing risk from craving than from depressive mood at Baseline.

Read Full Abstract

Request Reprint E-Mail:

Negative urgency, problem drinking and negative alcohol expectancies among members from one First Nation: A moderated-mediation model

Problematic alcohol use is a major health concern for many Native communities in both Canada and the United States (Spillane & Smith, 2007, 2010; Spillane, Smith, & Kahler, in press). Because health disparities related to alcohol use are pronounced in this population ( and ), it is important to study factors that may contribute to risk for this set of problems. Alcohol expectancies represent a well known risk factor for alcohol use in non-Natives.

This study sought to examine the relationship between negative urgency and negative alcohol expectancies, and to determine if this relationship is influenced by problem drinking behaviors.

We hypothesized that negative urgency's effects on the development of negative alcohol expectancies would be mediated by negative urgency's influence to increase drinking behaviors in a First Nation sample (see (Spillane & Smith, 2010). We also hypothesized that this relationship would be moderated by sex.

We administered measures of alcohol use, negative urgency, and negative alcohol use expectancies to a total of 209 First Nation people (96 men; 113 women).

Following the steps of moderated mediation outlined by Preacher, Rucker, & Hayes (2007), we found that the relationship between negative urgency and negative alcohol expectancies was significantly mediated by problem drinking for males (
β = 0.42, p < .001), but not for females (β = 0.13, p = .32).

The current study suggests that for males in this First Nation sample, negative urgency's effects on development of negative alcohol expectancies is mediated by problem drinking behavior.

Read Full Abstract

Request Reprint E-Mail:

The Role of Heavy Episodic Drinking and Hostile Sexism in Men's Sexual Aggression Toward Female Intimate Partners

Research indicates that men's heavy episodic drinking is a significant risk factor for their perpetration of sexual aggression toward intimate partners. The aim of this investigation was to examine how hostile sexism (i.e., antipathy toward women) and benevolent sexism (i.e., subjectively positive, yet patriarchal, views of women) influence the relation between men's heavy episodic drinking and their perpetration of sexual aggression toward intimate partners.

Participants were 205 heterosexual drinking men who completed self-report measures of quantity of alcohol consumption during the past 12 months, hostile sexism, and sexual aggression toward an intimate partner during the past 12 months.

Men's heavy episodic drinking was positively associated with sexual aggression perpetration toward intimate partners amongst men who endorsed high, but not low, levels of hostile sexism. No such interactive effect emerged for men's endorsement of benevolent sexism.

These results have important implications for understanding cumulative risk factors for the perpetration of sexual aggression toward intimates.

Read Full Abstract

Request Reprint E-mail:

Examination of the latent factor structure of the Alcohol Use Disorders Identification Test in two independent trauma patient groups using confirmator

Recent research on the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) provides support for two underlying factors: consumption and consequences.

The current study sought to extend these findings to two independent and diverse trauma populations: traumatic injury patients and military veterans treated for posttraumatic stress disorder.

The 2- and 3-factor solutions provided the best fit to the data, but there was a very high correlation between the second and third factors of the 3-factor solution.

Parsimony suggests that the 2-factor solution is the preferred model. The 2-factor model has implications for alcohol screening using the AUDIT and supports the goal of screening to identify those with hazardous drinking and alcohol use disorders.

An algorithm is proposed to inform alcohol screening protocols in a range of health settings for trauma-exposed patient groups.

Read Full Abstract

Request Reprint E-Mail:

Does the Alcohol Use Disorders Identification Test–Consumption identify the same patient population as the full 10-item Alcohol Use Disorders Identifi

The aim of this study was to evaluate whether a computer-based 3-item version (Alcohol Use Disorders Identification Test–Consumption [AUDIT-C]) of the Alcohol Use Disorders Identification Test (AUDIT) identifies alcohol use disorder (AUD) in the same patients as the full 10-item version in 809 women and 747 men in an anesthesiology preoperative assessment clinic.

According to cutoffs used (AUDIT: 5–8 points, AUDIT-C: 4–6 points), rate of disagreement (AUDIT-positive and AUDIT-C-negative or vice versa) ranged between 4% and 31% (men) and between 4% and 19% (women).

In male patients, 15% were positive for both the AUDIT (≥8 points) and the AUDIT-C (≥6 points), 7% were positive for AUDIT-C only, and 4% were positive for AUDIT only.

In female patients, using cutoffs of 5 more points (AUDIT) and 4 or more points (AUDIT-C), 16% were positive for both versions, 9% were positive for AUDIT-C only, and 2% were positive for AUDIT only.

The AUDIT and AUDIT-C seem to identify AUD in differing patients.

Read Full Abstract

Request Reprint E-Mail:

Overview of Alcohol Consumption

People drink to socialize, celebrate, and relax. Alcohol often has a strong effect on people – and throughout history, we’ve struggled to understand and manage alcohol’s power. Why does alcohol cause us to act and feel differently? How much is too much? Why do some people become addicted while others do not?

'Community Alcohol Networks: A Practitioners Toolkit' - Lancashire partnerhsip approach to young people's drinking

In Lancashire, Community Alcohol Networks (CANs) have been developed by the Trading Standards Alcohol and Tobacco team, in conjunction with Lancashire Constabulary, to adopt a partnership approach to reduce alcohol-related crime and problems amongst young people.

Lancashire have released a CAN Practitioner Toolkit and a CAN Problem Oriented Partnership report.

The project was established with the aims of reducing young people's access to alcohol in order to reduce risky drinking and alcohol fuelled anti social behaviour. It also aimed to reduce problems by tackling proxy purchasing through enhanced enforcement activity in identified hotspots. In addition it aimed to raise awareness of alcohol related health and social issues amongst young people, parents and the wider community.

Over 12 weeks the Community Alcohol Networks were claimed to have achieved :

  • 51 per cent reduction in alcohol fuelled anti social behaviour
  • violent crime has reduced by 22 per cent
  • criminal damage has seen an 11 per cent reduction > > > > Read More

Press Release - Risk of Alcohol Abuse May Increase After Bariatric Surgery

Among patients who underwent bariatric surgery, there was a higher prevalence of alcohol use disorders in the second year after surgery, and specifically after Roux-en-Y gastric bypass, compared with the years immediately before and following surgery, according to a study in the June 20 issue of JAMA. This study is being published early online to coincide with its presentation at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

“As the prevalence of severe obesity increases in the United States, it is becoming increasingly common for health care providers and their patients to consider bariatric surgery, which is the most effective and durable treatment for severe obesity. Although bariatric surgery may reduce long-term mortality, and it carries a low risk of short-term serious adverse outcomes, safety concerns remain. Anecdotal reports suggest that bariatric surgery may increase the risk for alcohol use disorders (AUD; i.e., alcohol abuse and dependence),” according to background information in the article.

The authors add that there is evidence that some bariatric surgical procedures (i.e., Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy) alter the pharmacokinetics of alcohol. “Given a standardized quantity of alcohol, patients reach a higher peak alcohol level after surgery compared with case-controls or their preoperative levels.” > > > > Read More