Aims

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.

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Monday, November 5, 2012

Life in Recovery Survey



Faces & Voices is excited to conduct the first nationwide survey designed to document key aspects in the lives of people in recovery from addiction to alcohol and other drugs. While much is known about the many costs of addiction, we know very little about what happens in a person’s life in recovery. We are gathering this information to inform the public, policymakers, service planners and providers and the recovery community – about the milestones that people achieve in recovery. The information will contribute to educating the public about recovery and to address discriminatory barriers facing people in or seeking recovery from addiction to alcohol and other drugs.  > > > >  Read More
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Acceptance of Non-Abstinence Goals by Addiction Professionals in the United States.




Previous research has found relatively limited acceptance of nonabstinence goals in addiction treatment settings in the United States. Because such attitudes may have changed over time, this study was designed to assess the current acceptance of nonabstinence goals by addiction professionals as a function of type of substance (alcohol vs. drug), severity of the disorder (DSM–IV abuse vs. DSM–IV dependence), and finality of the outcome goal (intermediate vs. final). 

 The sample comprised 913 members of a national association of addiction professionals who completed a web-based survey. Over one half of respondents rated nonabstinence as somewhat or completely acceptable as both an intermediate and final outcome goal for clients with alcohol abuse, but considerably smaller proportions rated nonabstinence an acceptable intermediate or final outcome goal for clients with alcohol dependence. Regarding drug-taking clients, one half and one third of respondents rated nonabstinence at least somewhat acceptable as an intermediate goal and final outcome goal, respectively, for clients with drug abuse, but fewer rated nonabstinence an acceptable outcome goal for clients with drug dependence.

One implication of the findings is that individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that—depending on the severity of their condition, the finality of their nonabstinence goal, and their drug of choice—their interest in moderating their consumption will be acceptable to many clinicians, especially those working in outpatient and independent practice settings.


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Request Reprint E-Mail:    ddiab@bgsu.edu
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Aboriginal women, alcohol and the road to fetal alcohol spectrum disorder





“The girls don’t drink much; ’bout the same as the fellas”

I am an Aboriginal woman, with traditional connections to the Bidjara people from central western Queensland and extensive experience in working with Aboriginal women who consume alcohol during pregnancy.
During several decades of working in the health field, I have asked myself and others why Aboriginal people drink alcohol at such dangerous levels.
As I have reported earlier,1 I believe that the historical and political background and the cultural aspects of drinking have been insufficiently considered. There is an entrenched expectation of Aboriginal community members that to drink is an expression of identity and culture.  > > > >   Read More
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Alcohol News - 45/2012



 

Science Nordic (Norway) - Abstinent mothers require better support
Drug-abusing mothers who become drug-free during their pregnancy have trouble understanding the needs of their babies. New research suggests they should receive greater follow-up after giving birth.
Reuters (Finland) - The nearer the bar, the greater the chances of risky drinking
Does living near a bar encourage people to overindulge, or do heavy drinkers move to neighborhoods with easy access to alcohol? A new study suggests it may be the former for some people. Researchers in Finland found that of nearly 55,000 Finnish adults followed for seven years, those who moved closer to bars were somewhat more likely to increase their drinking.
Helsinki Times (Finland) - Alcohol is a central source of society’s ills
Heavy alcohol consumption is a central factor of the ills in our society. The problems it causes are reflected far and wide. It is regrettable that achieving open discussion and effective decisions is laborious. According to a number of experts, downplaying the issues caused by alcohol is too common. Too often, alcohol use is considered to be a natural part of everyday life.
The Local (Sweden) - Sweden’s alcohol-free drink label 'misleading'
Most of the alcohol-free drinks sold in Sweden’s state-run liquor store monopoly Systembolaget actually contain alcohol, with experts calling the label “misleading” and a threat to recovering alcoholics.
Reuters - Many HIV patients skip medications to drink: study
About half of HIV patients on antiretroviral therapy skipped their medications whenever they were drinking alcohol, according to a U.S. study - an ill-advised behavior that researchers say could lead to higher viral loads.
PsychCentral.com - Alcohol Abuse Common among Bullies, Victims
A new study suggests both school bullies and their victims are likely to abuse alcohol after a bullying episode.
Tribune-Review (Russia) - Putin cracks down on tobacco, alcohol
Vladimir Putin is waging the biggest public health drive since former Soviet leader Mikhail Gorbachev failed to wean his country off alcohol abuse with a crackdown on tobacco and drink.
Western Herald (USA) - Alcohol affects students’ academic performance, health
With Halloween festivities well underway, many WMU students have had their share of adult beverages in the past several days. What these students may not realize is that if excessively used, these beverages can have a negative impact on performance.
The Australian (Australia) - More tax on booze would benefit us: report
ORDERING a schooner at the pub may cost more if proposed alcohol taxation reforms are taken up by the federal government.
3News NZ (New Zealand) - Alcohol and drug court launched
The first Alcohol and Other Drug Treatment Court in Auckland aims to help 100 offenders each year deal with underlying addiction issues.
VOA Khmer (Cambodia) - Fetal Alcohol Syndrome a Risk for Cambodians
When a woman drinks alcohol during pregnancy she risks giving birth to a child with mental and physical defects called fetal alcohol syndrome, a US-based doctor told “Hello VOA” on Thursday.
EurasiaNet - Uzbekistan: Alcohol Sales Drying Up in Tashkent
A month after a law restricting alcohol sales in Uzbekistan came into force, trade in beer, wine and spirits – over the counter at least – has dried up in downtown Tashkent.
Scotsman (Scotland) - Alcohol ban on Scotland’s trains branded a success
SCOTLAND’S largest train operator says its new policy on curtailing alcohol consumption has been a success.
Medical Daily - Heavy Alcohol Use During Pregnancy Shrinks Child's Brain
Heavy alcohol exposure in the womb leads to poor development of the child's brain, says a new study supported by National Institutes of Health. The effects of the brain's poor development remain until later in life.
The Guardian (UK) - Drinks industry refuses to swallow government line on alcohol pricing
Despite general agreement that something must be done about Britain's booze culture, opinions remain divided over plans to introduce a minimum unit price.
Medical Xpress - Alcohol increases activity of the resting brain in social drinkers
Short-term alcohol intake can increase the activity of functional connections across the human brain when it is at rest, according to research published Oct 31 in the open access journal PLOS ONE by Panagiotis Bamidis and colleagues from the Aristotle University of Thessaloniki, Greece.
The Australian (Australia) - Hard to ban grog supply to kids: inquiry
ONLY parents legally defined as "responsible" should be able to supply their kids with alcohol, a NSW parliamentary inquiry has heard.
The Canberra Times (Australia) - Baseball says no to alcohol sponsorship
When it comes to discouraging alcohol sponsorship in sport, the federal government is putting its money where its mouth is - offering $25 million in replacement sponsorship deals if sporting bodies cut ties with big booze.
The Independent (Russia) - Putin wages war on vodka as lifestyle death toll at 90,000
Vladimir Putin is waging the biggest public health drive since former Soviet leader Mikhail Gorbachev failed to wean his country off alcohol abuse with a crackdown on tobacco and drink.
Herald Scotland (Scotland) - MSPs endorse move for stricter drink-drive limit
MSPs have backed plans for a law change to reduce the drink-drive limit, as a new survey found seven out of ten Scots supported the move.
BBC News (France) - France's beer tax rise: Fears in industry
Taxes on beer are set to increase by more than 160% under a controversial new law being pushed through the French parliament.
Irish Health (Ireland) - Call for minimum pricing on alcohol
Almost 30 charities, community groups and organisations representing medical staff have joined forces to call on the government to introduce minimum pricing for alcohol.
Sydney Morning Herald - The drink twice as deadly for women
Drinking too much too often is twice as fatal for women as men, according to new research that has prompted GPs to call for screening of female patients for excessive alcohol consumption.
Caerphilly Observer (Wales) - Hundreds of lives in Wales saved from drug and alcohol misuse
Hundreds of lives have potentially been saved across Wales in the battle against drug and alcohol misuse in the last year, a report published yesterday (October 31) has suggested.


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The 2nd National Emergency Department survey of Alcohol Identification and Intervention activity




Alcohol identification and brief advice (IBA) in the Emergency Department is an effective and cost effective method to reduce levels of alcohol consumption and alcohol related harm. This finding has been translated into UK alcohol policy guidelines by the Department of Health. The recent NICE guidelines “Preventing the development of hazardous and harmful drinking” also commend the use of screening tools and the delivery of brief advice in the ED. To determine the extent to which the continuing recommendations for the provision of alcohol screening and brief advice have been adopted by EDs, a survey of all English EDs was undertaken. This survey followed up on our previous National Survey, with more specific questions regarding access to training on screening and brief interventions.

 A cross sectional survey targeting all 187 consultant led Emergency Departments in England. A questionnaire based upon the previous national survey was developed and made available in both print and online versions. Anonymity of respondents was preserved by utilising an Identity Number.
In the first instance, a questionnaire was sent to the “Lead Clinician” of each ED. Each questionnaire also contained a return address, a link to the online version of the survey and details to allow the return of completed materials via electronic methods. Two weeks after the initial mail-shot, non-responding departments were sent an Email version of the cover letter and questionnaire. Two weeks after the initial email contact, a second wave of emails was sent to remaining non-responders, and two weeks after that a final round of telephone and email contacts was undertaken.

 A total of 153 departments (of 187 contacted) responded to the survey (81.8% response rate). There was a significant reduction (-17.9%) in participating departments compared to the previous national survey, however over 80% of EDs did complete the questionnaire.

When compared to the results of the previous National Survey there have been significant increases in routine questioning about alcohol consumption (+35.0%), the use of a formal alcohol screening questionnaire (+49.6%), the provision of help / advice about alcohol problems (+22.1%) and access to Alcohol Health Workers (AHW) or Clinical Nurse Specialists (CNS) (+54.9%).

 More than half of all departments (57.6%) indicated that their ED had an “alcohol champion” – a specific member of staff who took responsibility for alcohol issues. There was a significant association between the presence of a champion and access to training on screening.

 Almost every department (98.7%) asked adult patients about their alcohol consumption with about half asking such questions routinely and using a standardised screening tool. The Paddington Alcohol Test was the most frequently used screening tool (40.5%), with the AUDIT-C (23.0%) and FAST (14.9%) also accounting for most screening activity.

 Every department offers some sort of help or advice (i.e. leaflets, advice or specialist referrals) for patients who might have an alcohol problem. The help / advice provided by about half of all departments was a referral to their own “in house” specialist team, with about a quarter referring patients to an external agency. Some department staff also provided an intervention themselves as either a leaflet or “Brief Advice” (1-2 minutes of structured advice about their level of alcohol consumption). The majority of departments had access to at least one Alcohol Health Worker/ Community Nurse Specialist, usually based on-site.

 The results of this survey of alcohol identification and brief advice activity show that, compared to the earlier 2006 survey, levels of screening, provision of help / advice and access to AHW / CNS services have all increased significantly. Departments are beginning to identify local alcohol “champions”, and this is associated with an increase in the provision of training in both identification and brief intervention. The increased use of formal alcohol screening measures, often applied routinely, suggests that English EDs are beginning to maximise the likelihood of identifying those patients who may benefit from further help or advice about their alcohol consumption. The four fold increase in access to specialist services for such patients should serve to also ensure that those who require help are exposed to interventions that are both effective and cost effective. To conclude; alcohol no longer represents a missed opportunity in the ED. Departments are to be commended upon their progress towards the integration of alcohol IBA into routine practice; this increased focus upon alcohol affords a chance to instigate change for the betterment of the patient, the department and the wider health service.

Read Full Report   (PDF)
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Ethanol consumption impairs the hemodynamic response to hemorrhagic shock in rats




Alcohol intoxication can exacerbate hemodynamic instability following hemorrhagic shock. Impairment of hormonal, neurohumoral, and immune responses can contribute to such instability; however, the relationship between blood alcohol levels and the progression of hemorrhagic shock accompanied with these responses has not been clearly demonstrated. 

 Herein, we examined this relationship in rats treated with various dose of alcohol. After oral administration of alcohol and then hemorrhage, the recovery of mean blood pressure (MBP); increase in plasma level of norepinephrine, epinephrine, and vasopressin; and survival interval decreased in a dose-dependent manner as the blood alcohol level increased. 

 There were no significant differences in the production of proinflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin (IL)-1β among the groups. 

 The present results demonstrated alcohol aggravates hemorrhagic shock in a dose-dependent manner not by alerting the immune response, but by suppressing hormonal and neurohumoral responses, thereby inhibiting hemodynamic autoregulation and shortening the survival interval.
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 Request Reprint E-Mail:  h-sato@med.uoeh-u.ac.jp
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Effect of dissolved oxygen in alcoholic beverages and drinking water on alcohol elimination in humans



Oxygen plays an important role in the metabolism of alcohol. An increased dissolved oxygen level in alcoholic beverages reportedly accelerates the elimination of alcohol. Therefore, we evaluated the effect of dissolved oxygen in alcohol and the supportive effect of oxygenated water on alcohol pharmacokinetics after the excessive consumption of alcohol, i.e., 540 ml of 19.5% alcohol (v/v).

Fifteen healthy males were included in this randomized, 3 × 3 crossover study. Three combinations were tested: X, normal alcoholic beverage and normal water; Y, oxygenated alcoholic beverage and normal water; Z, oxygenated alcoholic beverage and oxygenated water. Blood alcohol concentrations (BACs) were determined by conversion of breath alcohol concentrations. Four pharmacokinetic parameters (Cmax, Tmax, Kel, and AUCall) were obtained using non-compartmental analysis and the times to reach 0.05% and 0.03% BAC (T0.05% and T0.03%) were compared using one-way analysis of variance (ANOVA) and Duncan's post hoc test. 

 With combination Z, the BAC decreased to 0.05% significantly faster (p < 0.05) than with combination X.

Analyzing the pharmacokinetic parameters, the mean Kel was significantly higher for combination Z than for combinations X and Y (p < 0.05), whereas the mean values of Cmax, Tmax and AUCall did not differ significantly among the combinations. 

 Dissolved oxygen in drinks accelerates the decrease in BAC after consuming a large amount of alcohol. However, the oxygen dissolved in the alcoholic beverage alone did not have a sufficient effect in this case. 

 We postulate that highly oxygenated water augments the effect of oxygen in the alcoholic beverage in alcohol elimination. Therefore, it is necessary to investigate the supportive effect of ingesting additional oxygenated water after heavy drinking of normal alcoholic beverages.
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 Request Reprint E-Mail:    kwon@cnu.ac.kr
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Severity of alcohol dependence in the Swedish adult population: Association with consumption and social factors




The severity of alcohol dependence can be estimated by the number of DSM-IV criteria that are fulfilled for this disorder. This paper describes the proportions in a general population sample that meet different numbers of diagnostic criteria for alcohol dependence and their association with drinking and social background factors.

 Data came from a random, cross-sectional, self-report survey of adults from 12 Swedish communities. 28,800 persons, age 19–70, were surveyed through postal questionnaires. 14,706 questionnaires (51%) could be used for analysis. Alcohol dependence was assessed by questions relating to the seven DSM-IV criteria for alcohol dependence. Alcohol consumption and social background factors were examined in relation to alcohol dependence. 

 A total of 73.8% of the general population fulfilled no criteria for alcohol dependence; 4.0% reported 3 or more criteria and qualified for the diagnosis of alcohol dependence. There were trends toward an increasing number of dependence criteria with increasing consumption levels and negative social background factors. The majority of people with alcohol dependence however did not drink at the highest consumption levels, did not live alone, and were not unemployed.

 Given the current definition of alcohol dependence the majority of people have few criteria fulfilled (3 or 4) and few social problems. This has important implications for treatment as dependence with low severity may require less treatment and less specialist involvement.
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 Request Reprint E-Mail:  sven.andreasson@ki.se
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Dose–response relationship between in-hospital mortality and alcohol following acute injury



Although the relationship between alcohol and injury incidence is well researched, there continues to be dispute about the relationship between alcohol and mortality following an injury. Findings from past studies have varied primarily because of methodological issues and have failed to characterize the dose–response relationship. 

 The main objective of this study was to evaluate the dose response relationship of in-hospital mortality and blood alcohol concentration (BAC). This study was a retrospective analysis of traumatic injuries occurring between 1995 and 2009 as reported by all level 1 and 2 trauma units in the State of Illinois. 

 The study includes all patients with blood alcohol toxicological examination levels ranging from zero to 500 mg/dl (N = 190,612). The Illinois trauma registry includes all patients sustaining traumatic injuries and admitted to a trauma center for ≥12 h. A total of 6733 patients meeting the inclusion criteria died following admission. Patients that were dead on arrival and those that died during the initial assessment within the emergency room were excluded. 

 In the adjusted multivariable model, a decrease in in-hospital mortality was strongly associated with an increase in blood alcohol concentration (adjusted OR = 0.83 per 100 mg/dl units change in BAC; CI 95%: 0.80, 0.85; p < 0.001). The direction of the dose response relationship was consistent across the stratified models, with the exception of patients suffering burns.

The largest reduction of in-hospital case fatality rates by blood alcohol concentration was observed among patients suffering penetrating or severe injuries (Injury Severity Score ≥ 16). In the clinical setting, it is important to understand not only how to recognize intoxicated patients, but also how alcohol may affect the course of treatment. 

 The consistency of the findings across the multivariable models indicates that blood alcohol concentration is strongly associated with lower in-hospital mortality among those that survive long enough to receive treatment in specialized trauma units.
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Request Reprint E-Mail:      lfriedman@tspri.org
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Effect of repetitive daily ethanol intoxication on adult rat brain: Significant changes in phospholipase A2 enzyme levels in association with increased PARP-1 indicate neuroinflammatory pathway activation



Collaborating on studies of subchronic daily intoxication in juvenile and adult rats, we examined whether the repetitive ethanol treatments at these two life stages altered levels of key neuroinflammation-associated proteins—aquaporin-4 (AQP4), certain phospholipase A2 (PLA2) enzymes, PARP-1 and caspase-3—in hippocampus (HC) and entorhinal cortex (EC). Significant changes in the proteins could implicate activation of specific neuroinflammatory signaling pathways in these rats as well as in severely binge-intoxicated adult animals that are reported to incur degeneration of vulnerable neurons in HC and EC. 

 Male Wistar rats, ethanol-intoxicated (3 g/kg i.p.) once daily for 6 days over an 8-day interval beginning at 37 days old and repeated at age 68–75 days, were sacrificed 1 h after the day 75 dose (blood ethanol, 200– 230 mg/dl). 

Analysis of HC with an immunoblot technique showed that AQP4, Ca+2-dependent PLA2 (cPLA2 IVA), phosphorylated (activated) p-cPLA2, cleaved (89 kD) PARP (c-PARP), and caspase-3 levels were significantly elevated over controls, whereas Ca+2-independent PLA2 (iPLA2 VIA) was reduced ∼70%; however, cleaved caspase-3 was undetectable. 

 In the EC, AQP4 was unchanged, but cPLA2 and p-cPLA2 were significantly increased while iPLA2 levels were diminished (∼40%) similar to HC, although just outside statistical significance (p = 0.06). In addition, EC levels of PARP-1 and c-PARP were significantly increased. 

 The ethanol-induced activation of cPLA2 in association with reduced iPLA2 mirrors PLA2 changes in reports of neurotrauma and also of dietary omega-3 fatty acid depletion. 

 Furthermore, the robust PARP-1 elevations accompanied by negligible caspase-3 activation indicate that repetitive ethanol intoxication may be potentiating non-apoptotic neurodegenerative processes such as parthanatos. 

 Overall, the repetitive ethanol treatments appeared to instigate previously unappreciated neuroinflammatory pathways in vivo. 

 The data provide insights into mechanisms of binge ethanol abuse that might suggest new therapeutic approaches to counter neurodegeneration and dementia.
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Request Reprint E-Mail:    mcollin@lumc.edu
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Confounding and studies of ‘moderate’ alcohol consumption: the case of drinking frequency and implications for low-risk drinking guidelines





Many observational studies suggest that increased drinking frequency is associated with reduced mortality among those with low-dose alcohol consumption. The purpose of this paper was to examine whether frequent drinkers consume lower-risk amounts during drinking days or have favorable risk factor profiles compared with those who drink less frequently, and discuss implications for the larger debate about the limitations of non-randomized studies about ‘moderate’ drinking and the development of low-risk drinking guidelines.

Data from the 2008 Behavioral Risk Factor Surveillance System survey were used to characterize alcohol consumption characteristics and their relationship with risk factors among adult drinking men who consumed an average of fewer than two drinks per day and adult drinking adult women who consumed an average of less than one drink per day.

Those who drank relatively infrequently (14 or fewer days per month) consumed more during drinking days, were more likely to exceed the US Dietary Guidelines drinking limits (41.0% versus 9.7%) and had a larger proportion of drinking days that included binge drinking (13.4% versus 4.3%). Infrequent drinkers also had a higher prevalence of 13 of 15 risk factors assessed. Findings from analyses of those aged ≥40 years were similar.

Among those with low average alcohol consumption, infrequent drinkers drink more during drinking days and have unfavorable risk factors profiles compared with more frequent drinkers, suggesting that confounding may contribute to favorable associations with ‘moderate’ average alcohol consumption and increased drinking frequency observed in non-randomized studies.
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Request Reprint E-Mail:    tim.naimi@bmc.org
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Recruitment of medial prefrontal cortex neurons during alcohol withdrawal predicts cognitive impairment and excessive alcohol drinking



Chronic intermittent access to alcohol leads to the escalation of alcohol intake, similar to binge drinking in humans. Converging lines of evidence suggest that impairment of medial prefrontal cortex (mPFC) cognitive function and overactivation of the central nucleus of the amygdala (CeA) are key factors that lead to excessive drinking in dependence. However, the role of the mPFC and CeA in the escalation of alcohol intake in rats with a history of binge drinking without dependence is currently unknown.

To address this issue, we examined FBJ murine osteosarcoma viral oncogene homolog (Fos) expression in the mPFC, CeA, hippocampus, and nucleus accumbens and evaluated working memory and anxiety-like behavior in rats given continuous (24 h/d for 7 d/wk) or intermittent (3 d/wk) access to alcohol (20% vol/vol) using a two-bottle choice paradigm. 

 The results showed that abstinence from alcohol in rats with a history of escalation of alcohol intake specifically recruited GABA and corticotropin-releasing factor (CRF) neurons in the mPFC and produced working memory impairments associated with excessive alcohol drinking during acute (24–72 h) but not protracted (16 –68 d) abstinence.

  Moreover, abstinence from alcohol was associated with a functional disconnection of the mPFC and CeA but not mPFC and nucleus accumbens. 

 These results show that recruitment of a subset of GABA and CRF neurons in the mPFC during withdrawal and disconnection of the PFC–CeA pathway may be critical for impaired executive control over motivated behavior, suggesting that dysregulation of mPFC interneurons may be an early index of neuroadaptation in alcohol dependence.
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 Request Reprint E-Mail:   ogeorge@scripps.edu
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The Overlooked Obstacles for Achieving Millenium Development Goals



In an article on the web site of IOGT InternationalI Mr. Sumanasekara describes alcohol use as one of the overlooked obstacles for achieving the Millenium Development Goals (MDGs). Sumanasekara is the Executive Director of the Alcohol and Drug Information Centre in Colombo, Sri Lanka. His article was published on the International Day for the Eradication of Poverty.
- Ending the Violence of Extreme Poverty is possible only if alcohol issue is addressed as part of a comprehensive approach to eradicating poverty. Alcohol has diverse negative influences on people’s economic status while economic status in turn affects alcohol use in many ways. Alcohol can push people into poverty and lock them, their families and entire communities there over generations, says the Board Member of IOGT.
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Effectiveness of a Proactive Mail-Based Alcohol Internet Intervention for University Students: Dismantling the Assessment and Feedback Components in a Randomized Controlled Trial





University students in Sweden routinely receive proactive mail-based alcohol Internet interventions sent from student health services. This intervention provides personalized normative feedback on alcohol consumption with suggestions on how to decrease drinking. Earlier feasibility trials by our group and others have examined effectiveness in simple parallel-groups designs.

To evaluate the effectiveness of electronic screening and brief intervention, using a randomized controlled trial design that takes account of baseline assessment reactivity (and other possible effects of the research process) due to the similarity between the intervention and assessment content. The design of the study allowed for exploration of the magnitude of the assessment effects per se.

This trial used a dismantling design and randomly assigned 5227 students to 3 groups: (1) routine practice assessment and feedback, (2) assessment-only without feedback, and (3) neither assessment nor feedback. At baseline all participants were blinded to study participation, with no contact being made with group 3. We approached students 2 months later to participate in a cross-sectional alcohol survey. All interventions were fully automated and did not have any human involvement. All data used in the analysis were based on self-assessment using questionnaires. The participants were unaware that they were participating in a trial and thus were also blinded to which group they were randomly assigned.

Overall, 44.69% (n = 2336) of those targeted for study completed follow-up. Attrition was similar in groups 1 (697/1742, 40.01%) and 2 (737/1742, 42.31% retained) and lower in group 3 (902/1743, 51.75% retained). Intention-to-treat analyses among all participants regardless of their baseline drinking status revealed no differences between groups in all alcohol parameters at the 2-month follow-up. Per-protocol analyses of groups 1 and 2 among those who accepted the email intervention (36.2% of the students who were offered the intervention in group 1 and 37.3% of the students in group2 ) and who were risky drinkers at baseline (60.7% follow-up rate in group 1 and 63.5% in group 2) suggested possible small beneficial effects on weekly consumption attributable to feedback.

This approach to outcome evaluation is highly conservative, and small benefits may follow the actual uptake of feedback intervention in students who are risky drinkers, the precise target group.
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NICE release 'alcohol public health' briefing to assist local authorities




The National Institute for Clinical Excellence (NICE) have released an alcohol briefing (PHB6) as part of its suite of public health briefings for local government - see NICE press release.

NICE have based the guidance on its comprehensive set of resources, guidance and quality standards for the prevention and treatment of alcohol problems. NICE reccomond a two-pronged approach to alcohol misuse, with a combination of interventions aimed at the whole population and individuals.

 The briefing aims to support local government in its public health role, including its leadership of Health and Wellbeing boards forthcoming duty to commission alcohol misuse prevention and treatment interventions. As of April 2013 public health functions will be formally transferred from Primary Care Trusts to local authorities, some challenges explored in a recent Guardian public health article.  > > > >  Read More
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Dealing Responsibly with the Alcohol Industry in London



The 2012 UK Government's Alcohol Strategy for England and Wales has been welcomed broadly and resulted only in muted criticism within the UK public health community. This is despite strong continuities with previous alcohol industry constructions of the nature of the problem and preferred policy responses. This is probably because the strategy shows progress on the public health lobby's key issue of pricing of alcohol beverages. There are, however, many problems with the wider content of the strategy, showing little interest in much needed industry regulation other than on price, and an absence of commitment to investment in research. Some dilemmas posed for the research community are discussed.  > > > >  Read More
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