Not All Those Who Wander Are Lost: Examining the Impact of Sojourner Adjustment and Drinking Motives on Alcohol Consequences Experienced by Americans Studying in Foreign Countries

American students studying in foreign countries represent a unique group at risk for increased and problematic drinking. Examination of risk and protective factors for negative alcohol-related consequences can lead to the development of efficacious preventive interventions for reducing high-risk drinking while abroad. The present study examined the relationship between sojourner adjustment (i.e., the sociocultural and psychological adjustment of short-term residents in foreign environments), drinking motives, and alcohol-related consequences. 

Participants were 248 college students (81% women) who recently completed study-abroad trips and completed online surveys about their drinking motives and behavior, alcohol-related consequences, and sojourner adjustment. 

In general, positive sojourner adjustment (i.e., social interaction with host nationals, language development and use, and host culture identification) was protective against negative consequences, whereas negative sojourner adjustment (i.e., social interaction with co-nationals and homesickness/feeling out of place) was associated with increased reporting of consequences. Unexpectedly, the positive sojourner adjustment factor of cultural understanding and participation was associated with greater alcohol-related consequences. Social motives for drinking also predicted consequences. Drinking motives moderated several of the relationships between sojourner adjustment and consequences. 

Interest in and adoption of the host country culture may protect against problematic alcohol use; however, this may vary based on students' reasons for drinking. These findings support the need for further examination of sojourner adjustment in college students abroad and indicate potential areas for development of preventive interventions. 


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Request Reprint E-Mail:   epeder@uw.edu

Inverse Association Between Triglycerides-to-HDL-Cholesterol Ratio and Alcohol Drinking in Middle-Aged Japanese Men

Triglycerides-to-high-density-lipoprotein (HDL)-cholesterol ratio (TG/HDL-C ratio) has been proposed to be a useful predictor of cardiovascular disease. Habitual alcohol drinking causes elevation of triglycerides and HDL cholesterol levels. The purpose of this study was to determine how the TG/HDL-C ratio is influenced by alcohol intake. 

Subjects were 21,572 Japanese men (age range: 35–60 years) who were divided into non-, light (<22 alcohol="alcohol" analysis.="analysis." analysis="analysis" and="and" between="between" but="but" by="by" covariance="covariance" day="day" drinkers.="drinkers." ethanol="ethanol" font="font" g="g" heavy="heavy" intake="intake" investigated="investigated" logistic="logistic" nbsp="nbsp" of="of" ratio="ratio" regression="regression" relationship="relationship" tg="tg" the="the" using="using" very="very" was="was">

Log-transformed TG/HDL-C ratio was significantly lower in light, heavy, and very heavy drinkers than in nondrinkers and was lowest in light drinkers. Odds ratios for high TG/HDL-C ratios in light and heavy drinkers versus nondrinkers were significantly lower than a reference level of 1.00 (light drinkers: 0.63, 95% CI [0.57, 0.71], p < .01); heavy drinkers: 0.75, 95% CI [0.69, 0.81], p < .01]). Odds ratios for high waist-to-height ratio of subjects with versus subjects without high TG/HDL-C ratios were significantly higher than the reference level in non-, light, heavy, and very heavy drinkers and were significantly lower in heavy and very heavy drinkers than in nondrinkers (nondrinkers: 3.84 [3.42,4.31]; light drinkers: 3.65 [2.97,4.48]; heavy drinkers: 3.17 [2.84, 3.54], p < .05 compared with nondrinkers; very heavy drinkers: 2.61 [2.29, 2.97], p < .01 compared with nondrinkers).


Alcohol drinking is inversely associated with TG/ HDL-C ratio and confounds the relationship between TG/HDL-C ratio and obesity. 



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Request Reprint E-Mail:      wakabaya@hyo-med.ac.jp

Alcohol Use Disorders and Perceived Drinking Norms: Ethnic Differences in Israeli Adults

Individuals' perceptions of drinking acceptability in their society (perceived injunctive drinking norms) are widely assumed to explain ethnic group differences in drinking and alcohol use disorders (AUDs), but this has never been formally tested. Immigrants to Israel from the former Soviet Union (FSU) are more likely to drink and report AUD symptoms than other Israelis. We tested perceived drinking norms as a mediator of differences between FSU immigrants and other Israelis in drinking and AUDs. 

Adult household residents (N = 1,349) selected from the Israeli population register were assessed with a structured interview measuring drinking, AUD symptoms, and perceived drinking norms. Regression analyses were used to produce odds ratios (OR) and risk ratios (RR) and 95% confidence intervals (CI) to test differences between FSU immigrants and other Israelis on binary and graded outcomes. Mediation of FSU effects by perceived drinking norms was tested with bootstrapping procedures. 

FSU immigrants were more likely than other Israelis to be current drinkers (OR = 2.39, CI [1.61, 3.55]), have higher maximum number of drinks per day (RR = 1.88, CI [1.64, 2.16]), have any AUD (OR = 1.75, CI [1.16, 2.64]), score higher on a continuous measure of AUD (RR = 1.44, CI [1.12, 1.84]), and perceive more permissive drinking norms (p < .0001). For all four drinking variables, the FSU group effect was at least partially mediated by perceived drinking norms. 

This is the first demonstration that drinking norms mediate ethnic differences in AUDs. This work contributes to understanding ethnic group differences in drinking and AUDs, potentially informing etiologic research and public policy aimed at reducing alcohol-related harm.


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Request Reprint E-Mail:    ds1019@columbia.edu

Permissive Norms and Young Adults' Alcohol and Marijuana Use: The Role of Online Communities

Young adults are increasingly interacting with their peer groups online through social networking sites. These online interactions may reinforce or escalate alcohol and other drug (AOD) use as a result of more frequent and continuous exposure to AOD promotive norms; however, the influence of young adults' virtual networks on AOD use remains untested. The purpose of this study was to examine the association between the presence of AOD use content in online social networking, perceived norms (online norms regarding AOD use and anticipated regret with AOD use postings), and alcohol and marijuana use in a sample of 18- to 24-year-olds. 

Using an adapted web version of respondent-driven sampling (webRDS), we recruited a sample of 18- to 24-year-olds (N = 3,448) in the United States. Using multivariate regression, we explored the relationship between past-30-day alcohol and marijuana use, online norms regarding AOD use, peer substance use, and online and offline peer support. 

Alcohol use was associated with more alcohol content online. Anticipated regret and online peer support were associated with less alcohol use. Anticipated regret was negatively associated with marijuana use. Peer AOD use was positively associated with both alcohol and marijuana use. 

Peers play an important role in young adult alcohol and marijuana use, whether online or in person. Our findings highlight the importance of promoting online network-based AOD prevention programs for young adults in the United States. 


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Request Reprint E-Mail:   sastodda@umich.edu

Social Comparison as a Moderator of the Association Between Perceived Norms and Alcohol Use and Negative Consequences Among College Students

The present study aimed to extend previous research examining the relationships among perceived drinking norms, alcohol use, and related negative consequences by examining the moderating influence of social comparison orientation. 

A sample of 481 college students (44% male) completed a Web-based survey that assessed perceptions of drinking behavior, social comparison orientation, and alcohol use. 

The results suggested that social comparison orientation moderated the norm-behavior relationship such that the association between perceived drinking norms and alcohol-related negative consequences was stronger for those higher in social comparison. Results also showed that there was no moderation effect for alcohol consumption as the dependent variable. 

The findings of the present study are potentially important when developing efficacious alcohol prevention and intervention programs at colleges and universities and in considering more complex models of social influences on drinking.


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Request Reprint E-Mail:    dlitt@uw.edu

Sex Differences in Prevalence and Comorbidity of Alcohol and Drug Use Disorders: Results From Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

The present study examined sex differences in lifetime Axis I and II psychiatric comorbidity of DSM-IV alcohol use disorders (AUDs) and drug use disorders (DUDs) among general population U.S. adults. 

Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, Wave 2 lifetime prevalences of each disorder comorbid with alcohol abuse, alcohol dependence, drug abuse, and drug dependence were compared between men and women. Sex-specific associations of alcohol, any drug, and cannabis- and cocaine-specific abuse and dependence with each comorbid disorder were examined using logistic regression, first with adjustment for sociodemographic variables and then with additional adjustment for all other psychiatric disorders. 

Prevalences of most comorbid disorders differed significantly by sex among respondents with each AUD and DUD. However, after adjustment for sociodemographic characteristics and additional co-occurring psychiatric diagnoses, there were few sex differences in unique comorbid associations of specific AUDs and DUDs with specific psychiatric disorders

Rates of psychiatric disorders comorbid with AUDs and DUDs indicate large burdens of morbidity in both sexes, highlighting the need for careful assessment and appropriate treatment of both substance use and mental health disorders. The unique comorbid associations with AUDs and DUDs identified in this study further indicate the need for prospective etiological research to characterize these associations, their underlying mechanisms, and the possible sex specificity of those mechanisms. 


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bridget.grant@nih.gov

Establishment of an Immunodeficient Alcohol Mouse Model to Study the Effects of Alcohol on Human Cells in Vivo

The effects of alcohol (ethanol) are well documented and contribute to significant health problems and financial burden on the health care system. Several mouse models have been described that facilitate studies of the effects of alcohol on the mouse immune system. Our goal was to establish a chronic alcohol mouse model using the immunodeficient NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG) mouse. This severely immunodeficient model has previously been shown to allow efficient engraftment of human hematopoietic repopulating cells and cancer cells, thereby facilitating diverse studies on human hematopoiesis, immune cell function, and oncogenesis in vivo. 

NSG mice were provided ethanol in their drinking water as the only available fluid, starting at 5% weight/volume (w/v) and subsequently were increased to 10%, 15%, and 20% w/v. Mice were then maintained at 20% w/v, a level that models chronic alcohol use in humans. Alcohol consumption and weight were monitored. 

NSG mice readily consumed alcohol throughout the study and showed no adverse effects. No significant difference between group mean weights was identified the day before increasing the ethanol dose or at the end of 5 weeks at 20% w/v (p > .28). While the mice were maintained at 20% w/v ethanol, the mean daily ethanol intake was 27.2 g/kg of body weight, 32% of caloric intake. 

Here we have established a chronic alcohol mouse model using the powerful immunodeficient NSG mouse. This model should allow for novel studies on the effects of alcohol on engrafted human cells, including studies on the effects of alcohol on hematopoiesis, immunity, and cancer.


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Request Reprint E-Mail:   hzhang@wsu.edu

Low Sensitivity to Alcohol: Relations With Hangover Occurrence and Susceptibility in an Ecological Momentary Assessment Investigation

The current investigation tested whether low sensitivity to alcohol, as measured by the Self-Rating of the Effects of Alcohol (SRE) form, is associated with hangover occurrence or resistance, two potentially important predictors of later problematic drinking outcomes. 

Drinkers who reported using alcohol at least four times in the past month (N = 402) completed the SRE at baseline and used ecological momentary assessment methods with an electronic diary to record drinking behaviors and related experiences over 21 days. Each morning, the diary assessed prior-night drinking behaviors and the presence of current hangover. 

After adjustments for sex, body weight, age, and smoking status, higher SRE scores (indicating lower alcohol sensitivity) predicted hangover occurrence on postdrinking mornings (odds ratio [OR] = 1.24 per interquartile range [IQR], p = .003). However, when the number of drinks consumed in the drinking episode was covaried, SRE scores were negatively associated with hangover (OR = 0.67 per IQR, p <.001). An interaction between SRE scores and the number of drinks consumed indicated that low-sensitivity drinkers tend to be differentially resistant to hangover at a given number of drinks. Higher SRE scores were associated with consuming more drinks on average (generalized estimating equations coefficient = 2.20 per IQR, p <.001). 

Individuals lower in alcohol sensitivity appear to be more resistant to hangovers per unit of alcohol. However, they are also more likely to engage in excessive drinking, and this may account for their increased odds of experiencing hangover during an arbitrary monitoring period. Heavy consumption, hangover resistance, and hangover frequency may each be manifestations of low sensitivity to alcohol, an established risk factor for alcohol use disorder.


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Request Reprint E-Mail:    piaseckit@missouri.edu

Costs of Alcohol Screening and Brief Intervention in Medical Settings: A Review of the Literature

This article summarizes the literature on the implementation costs of alcohol screening and brief intervention (SBI) in medical settings.

Electronic databases were searched using SBI- and cost-related terms. Methodological approaches and cost estimates were abstracted from each study and categorized based on the cost methodology. Costs were updated to 2009 U.S. dollars. To determine a summary cost measure, we excluded outliers and computed the median of the remaining cost estimates. 

Seventeen studies with cost estimates were identified for further study. Costs ranged from $0.51 to $601.50 per screen and from $3.41 to $243.01 per brief intervention (BI). Cost estimates were lower when an activity-based cost methodology was used, in primary care settings, and when the provider was not a doctor. The median summary cost of a screen is approximately $4, and the median summary cost of a BI is approximately $48. 

Screening cost estimates had more variation than BI cost estimates. Provider type and service delivery time drive the cost variation. Interpretation of cost differences was limited by insufficient reporting of the cost methodology. Cost estimates presented here are similar in size to the Healthcare Common Procedure Coding System and Current Procedural Terminology reimbursement amounts, suggesting that insurance-based service reimbursement may be sufficient to sustain alcohol SBI in practice. 


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Request Reprint E-Mail:   bray rti.org

Systematic Review: Effect of Alcohol Intake on Adherence to Outpatient Medication Regimens for Chronic Diseases

Nonadherence to medications can lead to adverse health outcomes. Alcohol consumption has been shown to be associated with nonadherence to antiretroviral medications, but this relationship has not been examined at different drinking levels or with other chronic disease medications. We conducted a narrative synthesis of the association of alcohol consumption with nonadherence to medications for four chronic diseases. 

We searched MEDLINE, PsycINFO, Cochrane Library, and Web of Science for relevant studies published through 2009. To be included in this analysis, studies had to be quantitative; have a sample size of 50 or greater; and examine the effect of alcohol consumption on medication adherence for diabetes, hypertension, depression, or HIV/AIDS. Study characteristics and results were abstracted according to pre-specified criteria, and study quality was assessed. Study heterogeneity prevented a systematic synthesis. 

Sixty eligible studies addressed medication adherence for HIV in 47 (78%), diabetes in 6 (10%), hypertension in 2 (3%), both diabetes and hypertension in 1 (2%), depression in 2 (3%), and all medications in 2 (3%). Mean number of subjects was 245 (range: 5761,511). Effect sizes for the association of alcohol use with nonadherence varied (0.76–4.76). Six of the seven highest quality studies reported significant effect sizes (p < .05), ranging from 1.43 to 3.6. Most (67%) studies reporting multivariate analyses, but only half of non-HIV medicine studies, reported significant associations. 

Most studies reported negative effects of alcohol consumption on adherence, but evidence among non-HIV studies was less consistent. These data suggest the relevance of addressing 

alcohol use in improving antiretroviral adherence and a need for further rigorous study in non-HIV chronic diseases.

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Request Reprint E-Mail:   grodensk@med.unc.edu

Social Influences on the Clustering of Underage Risky Drinking and Its Consequences in Communities

The purpose of this research was to examine whether the clustering of underage risky drinking and its consequences within communities might arise from shared perceptions regarding underage drinking as well as the social context of drinking. 

The Enforcing Underage Drinking Laws Randomized Community Trial provided data from repeated cross-sectional samples of 5,017 current drinkers (2,619 male) ages 14–20 years from 68 communities surveyed in 2004, 2006, and 2007. Alternating logistic regressions were used to estimate the influence of social factors on the clustering of getting drunk, heavy episodic drinking, nonviolent consequences, and driving after drinking or riding with a drinking driver. 

The clustering of getting drunk, heavy episodic drinking, and nonviolent consequences was no longer statistically significant after adjustment for drinking with friends and drinking with parents. Parents providing alcohol explained the clustering of heavy episodic drinking and nonviolent consequences, whereas drinking with other underage drinkers and friends providing alcohol explained the clustering of nonviolent consequences. Drinking with friends or other underage drinkers and friends providing alcohol increased the risk of these behaviors, whereas drinking with parents and parents providing alcohol were protective. Perceptions regarding peer drinking, community norms, consequences for drinking, and drinking at a party did not influence clustering. 

These findings suggest that interventions to reduce underage risky drinking in communities should focus on the differential effects of the social context in which drinking occurs.     


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Request Reprint E-Mail:   brebouss@wakehealth.edu

Are Social Network Correlates of Heavy Drinking Similar Among Black Homeless Youth and White Homeless Youth?

Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) 

A probability sample of 235 Black and White homeless youths ages 13–24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. 

The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking.

This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth.


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Request Reprint E-Mail:   swenzel@usc.edu

Neighborhood Disadvantage and Adult Alcohol Outcomes: Differential Risk by Race and Gender

We examined whether relationships of neighborhood disadvantage with drinker status, heavy drinking, alcohol-related consequences, and dependence differed by race and/or gender. We hypothesized that neighborhood disadvantage would be negatively associated with drinker status but positively associated with heavy and problem drinking, with more pronounced relationships among African American and Hispanic men than other groups. 

Data consisted of nationally representative, randomly selected, cross-sectional samples of White, African American, and Hispanic adults (N = 13,864, of which 52% were female; with 7,493 drinkers, of which 48% were female) from the 2000 and 2005 National Alcohol Surveys merged with 2000 Census data. Analyses included logistic and linear regression using weights to adjust for sampling and nonresponse. 

Hypotheses were partly supported. Bivariate relationships were in the expected direction. Multivariate main effect models showed that neighborhood disadvantage was significantly associated with increased abstinence and marginally associated with increased negative consequences experienced by drinkers, but race/ethnicity and gender modified these associations. Disadvantage was significantly associated with increased abstinence for all groups except African American and Hispanic men. Among drinkers, disadvantage was significantly negatively associated with heavy drinking by Whites but significantly positively associated with heavy drinking by African Americans. Disadvantage also was associated with elevated alcohol-related consequences for White women and African American men. 

The findings have implications for the development of targeted interventions to reduce the unequal impacts of neighborhood disadvantage on alcohol outcomes. Future research should examine the contribution of multiple types of disadvantage to heavy drinking and alcohol problems. 


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London alcohol reports: Alcohol consumption in the night-time economy; Alcohol treatment pathways and outcomes

Two new alcohol reports for London have been released:

Alcohol Consumption in the Night Time Economy (NTE)

A new report from GLAEconomics assesses the most effective ways to mitigate costs associated with alcohol in the NTE. It is combined with an economic tool which estimates pros and cons for each London Local Authority.

• Section 1: What is the night-time economy (NTE) and what are the associated problems?
• Section 2: Why does the NTE generate these costs?
• Section 3: What to consider before developing a NTE policy?
• Section 4: What policy tools can reduce the problems associated with the NTE?

Download Alcohol consumption in the night-time economy.pdf or the summary and methodology.pdf. You can also access a pros and cons tool.xls. A recent report offered guidance on tackling NTE alcohol problems, or see our NTE categories list of posts.

Alcohol treatment: pathways and outcomes
In 2011 a London Alcohol Practitioners Forum event explored the variation between alcohol treatment pathways in London and how these could be improved. The report explores pathways, examples and outcome measures including Payment by Results (PbR):
Alcohol treatment: pathways and outcomes - a report of the practitioners event supported by the GLA, LDAN, LDAPF and other partners [pdf]s  > > > >   Read More

Working Memory Ability Predicts Trajectories of Early Alcohol Use in Adolescents: The Mediational Role of Impulsivity

) To evaluate the role of pre-existing weakness in working memory ability (WM) as a risk factor for early alcohol use as mediated by different forms of impulsivity. 2) To assess the adverse effects of progressive alcohol use on variations in WM over time.

A community sample of 358 adolescents [48% males, Mean_age(baseline) = 11.4 ± 0.87 years] from a longitudinal cohort design, assessed annually over four consecutive years with less than 6% attrition.

Repeated assessments were conducted for the following key variables: WM (based on performance on four separate tasks), frequency of alcohol use (AU), and three forms of impulsivity, namely sensation seeking (SS), acting-without-thinking (AWT) and delay discounting (DD). Latent growth curve modeling procedures were used to identify individual trajectories of change for all key variables.

Weakness in WM (at baseline) significantly predicted both concurrent alcohol use and increased frequency of use over the four waves (p <.05). This effect was entirely mediated by two forms of impulsivity, AWT and DD, both of which were characterized by underlying weakness in WM. No individual variation was observed in the slopes of WM, which suggests that individual variations in alcohol use were not associated with changes in WM in our early adolescent sample.

Early adolescent alcohol use may be a consequence of (pre-existing) weaknesses in working memory (WM) rather than a cause of it. Efforts to reduce early alcohol use should consider the distinct roles of different impulsivity dimensions, in addition to WM, as potential targets of intervention.


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Request Reprint E-Mail:   akhurana@asc.upenn.edu

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Process evaluation and feasibility study of In:tuition, a life skills education programme for young people aged 9-14 years

In November 2011 CSN, a community interest company, was appointed by Alcohol Research UK to undertake an initial, independent process evaluation and feasibility study of the implementation of In:tuition.
In:tuition is an evidence based, life skills education programme for young people aged 9-14, developed by Drinkaware. The programme consists of 10 primary lessons and 11 secondary lessons. It is based upon the Unplugged programme that has good evidence of effectiveness. Alcohol is its theme but the focus is much wider, including:

• self awareness
• attitudes and behaviour
• advertising, branding and the media
• personal choices
• emotions, communication skills and assertive behaviour
• the influence of peers
• goal setting and confidence

In:tuition is also digitally based to make the learning experience relevant and motivating. Home learning tasks are included to encourage discussion with parents/carers and promote consistent messages to young people at home and school.
The evaluation looked at the implementation of the programme in the classroom, how it was used, the extent to which it was implemented as intended, its acceptability to staff and students; its relevance and appropriateness, barriers to implementation and any requirements for additional support or training.
Schools provided initial information regarding their plans for piloting the programme. Feedback was collected from staff and pupils through online questionnaires, school visits, teacher interviews and pupil focus group discussions.   > > > >   Read More

Alcohol News - 41/2012

Copenhagen Post (Denmark) - Annual fall anti-drinking campaign underway

The first of October marks the beginning of the annual temperance campaign conducted by the national health board Sundhedsstyrelsen. The media blitz featuring print, broadcast and billboard ads focuses each year on the societal and individual health risks associated with drinking too much alcohol.

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ERR News (Estonia) - Medical Unions Propose Tax Hike on Light Alcoholic Beverages

Health care professionals are proposing that the money needed to meet their demands could be raised by bringing the excise tax on light alcoholic beverages level with the excise tax on strong alcoholic beverages.

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Sverige Radio (Sweden) - Alcohol home deliveries on the way in Stockholm

The government has decided that four areas in Stockholm county can have home delivery of alcohol from the state monopoly Systembolaget on a trial basis.

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Addictionts (Sweden) – New leads on the causes of alcoholism

In order to develop new medications for alcoholism, researchers need to understand how alcohol acts on the brain’s reward system. A previously unknown mechanism has been shown to block the rewarding effects of alcohol on the brain, reveals a thesis from the University of Gothenburg, Sweden.

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BBC News (UK) - Warning over middle class parents' alcohol habits

Too many middle class parents are drinking excessively as a way of coping with the demands of family life, a report suggests.

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The Telegraph (UK) - Beware British binge drinking, Cambridge video tells foreign students

A video urging new international students to steer clear of Britain's binge-drinking culture will be shown at Cambridge University this week.

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Irish Times (Ireland) - Time to break link between alcohol and sport

Should something as generally positive and healthy as sport be seen in bed with alcohol and all its attendant health risks?

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Scoience Codex - Moderate alcohol consumption may increase risk of atrial fibrillation in people with heart disease

Moderate alcohol consumption increases the risk of atrial fibrillation in older people with heart disease or advanced diabetes, found a study in CMAJ (Canadian Medical Association Journal).

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AllAfrica.com - East Africa: WHO Warns of Alcohol Deaths

More people in the East African Community (EAC) partner states are expected to die due to alcohol-related causes, the World Health Organisation (WHO) has warned.

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UPI.com - Smoking, alcohol tied to pancreatic cancer

The average age at which pancreatic cancer is found is 72, but U.S. researchers say those who smoke and drink heavily may develop it sooner.

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Daily Finance - NTRR Formulates Plan to Dramatically Reduce Global Alcohol Addiction

As the United States and other nations, struggle with high rates of alcohol abuse and addiction, Neutra Corp. (OTCBB: NTRR) is developing a business plan to help eliminate the social health costs that alcoholism wreaks around the globe.

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Ninemsn (Australia) - Alcohol warning can curb drinking: study

Negative warning labels on pre-mixed alcoholic drinks may help curb binge drinking among high-risk youths, research shows.

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Interfax (Ukraine) - Ukraine needs alcohol policy concept, experts say

Ukrainian medical professionals say Ukraine has to adopt a concept for an alcohol policy at the legislative level.

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stv.tv (Scotland) - Health Secretary 'firmly' believes minimum pricing meets European law

The Health Secretary still "firmly" believes that minimum pricing meets European law. Alex Neil also insisted that the measure is the "most effective and efficient way to tackle alcohol misuse in Scotland".

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Fetal Alcohol-Related Growth Restriction from Birth through Young Adulthood and Moderating Effects of Maternal Prepregnancy Weight

Fetal alcohol-related growth restriction persists through infancy, but its impact later in life is less clear. Animal studies have demonstrated important roles for maternal nutrition in fetal alcohol spectrum disorders, but the impact of prenatal maternal body composition has not been studied in humans. This study examined the effects of prenatal alcohol exposure on longitudinal growth from birth through young adulthood and the degree to which maternal weight and body mass index (BMI) moderate these effects.

Nearly 480 mothers were recruited at their first prenatal clinic visit to overrepresent moderate-to-heavy use of alcohol during pregnancy, including a 5% random sample of low-level drinkers and abstainers. They were interviewed at every prenatal visit about their alcohol consumption using a timeline follow-back approach. Their children were examined for weight, length/height, and head circumference at birth, 6.5 and 13 months, and 7.5, 14, and 19 years.

In multiple regression models with repeated measures (adjusted for confounders), prenatal alcohol exposure was associated with longitudinal reductions in weight, height, and weight-for-length/BMI that were largely determined at birth. At low-to-moderate levels of exposure, these effects were more severe in infancy than in later childhood. By contrast, effects persisted among children whose mothers drank at least monthly and among those born to women with alcohol abuse and/or dependence who had consumed ≥ 4 drinks/occasion. In addition, effects on weight, height, and head circumference were markedly stronger among children born to mothers with lower prepregnancy weight.

These findings confirm prior studies demonstrating alcohol-related reductions in weight, height, weight-for-height/BMI, and head circumference that persist through young adulthood. Stronger effects were seen among children born to mothers with smaller prepregnancy weight, which may have been because of attainment of higher blood alcohol concentrations in smaller mothers for a given amount of alcohol intake or to increased vulnerability in infants born to women with poorer nutrition.


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Request Reprint E-Mail:    RobertColin.Carter@childrens.harvard.edu

Chronic Alcohol Ingestion in Rats Decreases Krüppel-Like Factor 4 Expression and Intracellular Zinc in the Lung

Chronic alcohol ingestion alters the dynamic balance between granulocyte-macrophage colony-stimulating factor (GM-CSF) and transforming growth factor beta1 (TGFβ1) signaling within the alveolar space and, in parallel, impairs alveolar macrophage and epithelial cell function by inhibiting expression of the zinc importer ZIP4 and decreasing zinc bioavailability in the alveolar compartment. As the transcription factor Krüppel-like factor 4 (KLF4) binds to ZIP4, we hypothesized that alcohol exposure and consequent perturbations in GM-CSF and TGFβ1 signaling could decrease cellular KLF4 expression and/or binding as a mechanism by which it inhibits ZIP4 expression and decreases cellular zinc levels.

Alcohol exposure in vitro or chronic ingestion in vivo decreased KLF4 expression in alveolar macrophages and epithelial cells. Treatment with GM-CSF or TGFβ1 showed an enhancing or dampening effect on KLF4 expression and binding, respectively. Further, treatment of a rat alveolar macrophage cell line with alcohol in vitro for 4 weeks decreased the expression of the zinc transporters ZIP4 and ZNT1, and of the zinc storage protein metallothionein 1. In parallel, treating these macrophages with KLF4 siRNA decreased ZIP4 expression and decreased cellular zinc and phagocytic capacity to levels equivalent to those following alcohol exposure. In epithelial monolayers, transepithelial electrical resistance (TER) was significantly decreased by alcohol ingestion as compared with control diets, and it was restored by in vitro GM-CSF treatment. In contrast, in vitro TGFβ1 treatment of the epithelial monolayers from control-fed rats significantly decreased TER as compared with untreated control monolayers.

Taken together, these results suggest that within the alveolar space, chronic alcohol exposure decreases KLF4 and ZIP4 expression and consequently decreases zinc transport into cells, which, in turn, impairs their function. Furthermore, the dynamic decrease in the relative influence of GM-CSF versus TGFβ1 could mediate the zinc deficiency and consequent cellular dysfunction that characterize the “alcoholic lung” phenotype.

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Request Reprint E-Mail:    pcjoshi@emory.edu

Commentary: How Ethanol Short-Circuits the Cerebellum—Actions on Golgi Cells in Freely—Moving Animals

This commentary discusses the important contributions of the article published in this journal by Huang and colleagues, titled, “Acute ethanol exposure increases firing and induces oscillations in cerebellar Golgi cells of freely moving rats.” 

In this manuscript, Huang and colleagues present a number of interesting and important findings. While it has been shown previously that ethanol (EtOH) causes an increase in the firing of cerebellar Golgi cells in brain slice preparations and anesthetized animals, here the authors provide the first evidence that this action of EtOH occurs in vivo in freely moving, unanesthetized animals. 

These results also enhance our understanding of cerebellar functioning by describing the mechanism by which EtOH essentially de-afferentates (blocks specific inputs to) the cerebellum from the normal processing of sensory signals due to EtOH-induced Golgi neuron excitation, resulting in inhibition of granule cells. 

Furthermore, the authors characterize the novel observation of EtOH-induced neuronal oscillations, which was not previously observed in other preparations.


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Request Reprint E-Mail:    ron.freund@ucdenver.edu

Does Stress Increase Imitation of Drinking Behavior? An Experimental Study in a (Semi-)Naturalistic Context

That alcohol consumption is strongly influenced by the drinking behavior of social company has been demonstrated in observational research. However, not everyone is equally vulnerable to other people's drinking, and it is important to unravel which factors underlie these individual differences. This study focuses on the role of psychosocial stress in attempting to explain individual differences in the propensity to imitate alcohol consumption.

With a 2 (confederate's drinking condition: alcohol vs. soda) × 2 (participant's stress condition: stress vs. no stress) experimental design, we tested whether the tendency to imitate other people's drinking was related to participants' induced stress levels. The young male adults (N = 106) were randomly assigned to each of the conditions. In each session, directly after the stress or no-stress period, confederates and participants entered a bar laboratory where we observed their drinking behavior. Prior to entering the session, confederates were instructed to drink alcohol or soda.

Participants in both stress and no-stress conditions consumed substantially more alcohol when confederates drank alcohol than when they drank soda. There was no difference in alcohol consumed between stress and no-stress conditions. No moderating effect of stress on the tendency to drink along with peers was found.

Generally, it appears that among young male adults, imitation of alcohol consumption is a robust phenomenon not dependent on individual stress levels.


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Request Reprint E-Mail:   H.Larsen@uva.nl

Age of Onset and Neuropsychological Functioning in Alcohol Dependent Inpatients

Differences in clinical characteristics between early and late onset alcohol dependent patients have been examined intensively, but little is known about the differences in neuropsychological functioning between these patient groups. Clinical characteristics and neuropsychological functions of inpatients with early onset and late onset alcohol dependence are therefore investigated in this study.

Ninety-three abstinent alcohol dependent inpatients meeting a current diagnosis of DSM-IV alcohol dependence were divided into early onset alcohol dependent patients (EOA; ≤25 years; n = 36) and late onset alcohol dependent patients (LOA; >25 years; n = 57). Patients using psychoactive medication and patients dependent on other substances than alcohol (and nicotine) were excluded. A comprehensive neuropsychological test battery was administered.

EOA reported higher trait impulsivity, antisocial traits, and attention deficit hyperactivity disorder-related traits and exhibited an impulsive reflection style, especially in a high-risk context, compared with LOA. Against expectations, EOA performed significantly better on measures of planning, cognitive control, visual memory, and delayed recognition memory than LOA, whereas no significant group differences occurred on measures of delay discounting, digit span, and attention. Better Stroop interference, better visual memory, and a more impulsive reflection style was predictive of an early age of onset, and explained a significant and additional amount of variance (18.8%) on top of the clinical characteristics, together explaining 53.4% of the variance.

Both clinical characteristics and neuropsychological variables contributed independently to the age of onset of problematic alcohol use. Results indicate that especially an impulsive reflection style, besides higher trait impulsivity, may be the core feature of early onset alcohol dependence. However, the contribution of the neuropsychological variables is complex and more research is needed to clarify the role of psychiatric comorbidity and poly-substance abuse in an unselected sample of alcohol dependent patients.



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Request Reprint E-Mail:   leen.joos@ua.ac.be

ntranasal Oxytocin Blocks Alcohol Withdrawal in Human Subjects

The neuropeptide, oxytocin (OT), has been reported to block tolerance formation to alcohol and decrease withdrawal symptoms in alcohol-dependent rodents. Numerous recent studies in human subjects indicate that OT administered by the intranasal route penetrates into and exerts effects within the brain.

In a randomized, double-blind clinical trial, intranasal OT (24 IU/dose, N = 7) or placebo (N = 4) was given twice daily for 3 days in alcohol-dependent subjects admitted to a research unit for medical detoxification using Clinical Institute Withdrawal Assessment for Alcohol (CIWA) score-driven PRN administration of lorazepam. Subjects rated themselves on the Alcohol Withdrawal Symptom Checklist (AWSC) each time CIWA scores were obtained. Subjects also completed the Penn Alcohol Craving Scale, an Alcohol Craving Visual Analog Scale (ACVAS) and the Profile of Mood States (POMS) on inpatient days 2 and 3.

All subjects had drunk heavily each day for at least 2 weeks prior to study and had previously experienced withdrawal upon stopping/decreasing alcohol consumption. OT was superior to placebo in reducing alcohol withdrawal as evidenced by: less total lorazepam required to complete detoxification (3.4 mg [4.7, SD] vs. 16.5 [4.4], p = 0.0015), lower mean CIWA scores on admission day 1 (4.3 [2.3] vs. 11.8 [0.4], p < 0.0001) and day 2 (3.4 [2.2] vs. 11.1 [3.6], p < 0.002), lower AWSC scores on days 1 and 2 (p < 0.02; p = 0.07), and lower ACVAS ratings (p = 0.01) and lower POMS Tension/Anxiety subscale scores on day 2 (p < 0.01).

This is the first demonstration that OT treatment may block alcohol withdrawal in human subjects. Our results are consistent with previous findings in rodents that OT inhibits neuroadaptation to and withdrawal from alcohol. OT could have advantages over benzodiazepines in managing alcohol withdrawal because it may reverse rather than maintain sedative-hypnotic tolerance. It will be important to test whether OT treatment is effective in reducing drinking in alcohol-dependent outpatients.


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Request Reprint E-Mail:    cort_pedersen@med.unc.edu