The Current Situation of Treatment Systems for Alcoholism in Korea

Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. 

Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. 

However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.


Read Full Article    (PDF)

News Release - UTHealth researchers may help identify when smokers attempting cessation are at a higher risk of relapse

New findings by researchers at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health may help identify situations in which smokers who are trying to quit are at a higher risk of relapse.

More than 1,200 people die in the United States every day from smoking-related illnesses. This is equivalent to three airplanes loaded with passengers crashing everyday in America. Smoking-related illnesses are the No. 1 cause of preventable deaths in the country, killing more Americans than drugs, homicides, suicides, accidents, and fires combined.

Previous studies have indicated that alcohol use can increase smoking and smoking urges. However, no studies have examined the moment-to-moment relation between smoking urges and alcohol use during a smoking cessation attempt.  > > > >  Read More

Global Action - February 13, 2013

Key Recent Milestones:

· Mexico: ICAP announced the release of drink driving survey results at the Universidad de las Americas Puebla in Puebla, Mexico on February 12, 2013. The survey was conducted at the end of 2012 by UDLAP Consultores on alcohol consumption habits in Puebla.

Global Actions in Focus: Drink Drive Program in Thailand .

ICAP has released a summary report on the drink driving community road safety program review and training program in Thailand with the Population and Community Development Association (PDA). ICAP Consultant Robert Klein and ICAP Thailand Country Manager Khun Panasri met with community leaders from Khonkaen Province, Chang Rai Province, and PDA members on January 29 and 30, 2013.

The meeting covered drink driving initiatives implemented during the busy Loy Kratong and New Year festivals. Working plans for these campaigns were conducted in collaboration with sub-district municipalities. Activities included setting up breath alcohol checkpoints on superhighways and campaigning with drink driving messages on posters and community radio announcements. A memorandum of understanding was signed with PDA and the municipality of Mae Rai in Chang Rai Province to campaign on road safety.

“The report from campaign activities showed that no accidents, deaths, or injuries were recorded during the festivals in the target area of Banpai, Khonkean,” said Khun Panasri. “Figures also showed a reduction in sales of alcohol to youth.”

Program success was attributed to the willingness and collaboration of community leaders, sufficient funding, support and cooperation from government sectors, and the importance of continuous and repeating campaigns. The next steps are to expand the drink driving program to cover the entire sub-district, and to gain more breathalyzers for testing at checkpoints. ICAP and PDA are currently planning activities for educational campaigns during Songkran Festival.

What’s Happening Next:

· Belgium: ICAP is co-hosting the first Commitments Regional Workshop on February 21 and 22, 2013 in Brussels. CEOs of 13 of the world’s leading beer, wine, and spirits producers will discuss their collective commitment to 10 targeted actions in five areas over the next five years. 

Decreased effective connectivity in the visuomotor system after alcohol consumption

Functional magnetic resonance imaging (fMRI) allows observing cerebral activity not only in separated cortical regions but also in functionally coupled cortical networks. Although moderate doses of ethanol slowdown the neurovascular coupling, the functions of the primary sensorimotor and the visual system remain intact. Yet little is known about how more complex interactions between cortical regions are affected even at moderate doses of alcohol. 

Therefore the method of psychophysiological interaction (PPI) was applied to analyze ethanol-induced effects on the effective connectivity in the visuomotor system.

Fourteen healthy social drinkers with no personal history of neurological disorders or substance abuse were examined. In a test/re-test design they served as their own controls by participating in both the sober and the ethanol condition. All participants were scanned in a 3 T MR scanner before and after ingestion of a body-weight-dependent amount of ethanol calculated to achieve a blood alcohol concentration of 1.0‰. PPIs were calculated for the primary visual cortex, the supplementary motor area, and the left and right primary motor cortex using the statistical software package SPM.

The PPI analysis showed selective disturbance of the effective connectivity between different cortical areas. The regression analysis revealed the influence of the supplementary motor area on connected regions like the primary motor cortex to be decreased yet preserved. 

However, the connection between the primary visual cortex and the posterior parietal cortex was more severely impaired by the influence of ethanol, leading to an uncoupled regression between these regions. 

The decreased effective connectivity in the visuomotor system suggests that complex tasks requiring interaction or synchronization between different brain areas are affected even at moderate levels of alcohol. 

This finding may have important consequences for determining which components of demanding tasks such as driving a car might be compromised earlier than the functions of the main cortical motor and visual areas.


Read Full Abstract

Request Reprint E-Mail:    michael.luchtmann@med.ovgu.de

Addiction Industry Studies: Understanding How Proconsumption Influences Block Effective Interventions

The legalized consumption of products with addiction potential, such as tobacco and alcohol, contributes in myriad ways to poor physical and mental health and to deterioration in social well- being. These impacts are well documented, as are a range of public health interventions that are demonstrably effective in reducing harm.

I have discussed the capacity for the profits from these substances to be deployed in ways that block or divert resources from interventions known to be effective.

Addiction industry studies constitute a new and previously neglected area of research focusing specifically on understanding the salient relationships that determine policy and regulation. This understanding will increase the odds of adopting effective interventions.

Read Full Abstract

Request Reprint E-Mail:  p.adams@auckland.ac.nz

Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States

Our goal was to provide current estimates of alcohol-attributable cancer mortality and years of potential life lost (YPLL) in the United States.

We used 2 methods to calculate population-attributable fractions. We based relative risks on meta-analyses published since 2000, and adult alcohol consumption on data from the 2009 Alcohol Epidemiologic Data System, 2009 Behavioral Risk Factor Surveillance System, and 2009–2010 National Alcohol Survey.

Alcohol consumption resulted in an estimated 18 200 to 21 300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths.

Alcohol remains a major contributor to cancer mortality and YPLL. Higher consumption increases risk but there is no safe threshold for alcohol and cancer risk. Reducing alcohol consumption is an important and underemphasized cancer prevention strategy.

Read Full Abstract

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

Instigating Bystander Intervention in the Prevention of Alcohol-Impaired Driving: Analysis of Data Regarding Mass Media Campaigns

Research in the area of bystander intervention in the prevention of alcohol-impaired driving (AID) has mostly focused on the influence of existing factors (such as status or relationships) on the likelihood of intervening and has relied mostly on samples of college-age students. It remains unknown whether exposure to external stimuli, such as that of mass media marketing, has the ability to influence bystander intervention and whether differential tendencies to intervene hold true for the larger population. This study sought to explore the influence of external stimuli, in the form of mass media AID prevention messaging, on tendencies of bystander intervention and to determine other factors predictive of bystander intervention. 

The study relied on national, nonprobability survey data of mostly non-college-age respondents collected to assess anti-AID media campaigns. Analyses entailed a series of ordinary least squares and binary logistic regression models. 

Exposure to an AID media prevention campaign was not significantly related to individual concern over AID in the community or whether a bystander intervened to prevent an incident of AID. Seventy-six percent of respondents reported exposure to AID media prevention campaigns, whereas slightly more than 40% reported actually intervening to prevent an AID incident. Intervening bystanders had greater odds of being female and non-White and of perceiving the legal consequences of AID as being certain and severe. These factors, however, were mediated by respondent concern regarding the seriousness of the AID problem in their community. 

Findings suggest that AID media-based prevention messaging works best among those in the population who view AID as a serious problem in their community.


Read Full Abstract

Request Reprint E-Mail:   Guerette@fiu.edu

Contributions of Work Stressors, Alcohol, and Normative Beliefs to Partner Violence

A body of research has established that lower socioeconomic populations, including blue-collar workers, are at higher risk for problem drinking and intimate partner violence. This study of married/cohabiting construction workers and their spouses/partners describes how work stressors, hazardous drinking, and couple characteristics interact to influence normative beliefs around partner violence and, thereafter, its occurrence.

Our survey respondents from a sample of 502 dual-earner couples were asked about drinking patterns, past-year partner violence, normative beliefs about partner violence, work-related stressors, impulsivity, and childhood exposure to violence and other adverse events. We conducted semi-structured qualitative interviews with 81 workers on context of work stress, partner violence, and drinking. 

Analyses of data revealed that men's and women's normative beliefs about partner violence were positively related to male-to-female partner violence; female partner violence normative beliefs were associated with female-to-male partner violence. Both partners' levels of impulsivity were directly associated with male-to-female and female-to-male partner violence, and male partner's frequency of intoxication mediated the association between level of impulsivity and male-to-female partner violence. Female partner's adverse childhood experience was directly associated with male-to-female partner violence. Both survey and qualitative interviews identified individual and work-related factors that influence the occurrence of violence between men and women. 

These findings provide guidelines for prevention of partner violence that can be implemented in the workplace with attention to hazardous drinking, job stress, treatment, education, and work culture. 


Read Full Abstract

Request Reprint E-Mail:   ames@prev.org

Childhood Maltreatment, Alcohol Use Disorders, and Treatment Utilization in a National Sample of Emerging Adults

The purpose of this study was to examine the relationship between childhood maltreatment and alcohol use disorders (AUDs), treatment utilization, and barriers to treatment in a national sample of emerging adults. Multiple types of maltreatment were examined, including childhood emotional abuse and neglect. 

The analyses are based on data from 18- to 25-year-olds (N = 4,468) who participated in the National Epidemiologic Survey on Alcohol and Related Conditions. 

Adjusted for sociodemographic characteristics, we found that childhood maltreatment was associated with a greater likelihood of an AUD and a greater likelihood of accessing treatment, although these relationships were no longer significant once psychiatric comorbidities and other substance use disorders were included as control variables. We also found significant interaction effects for age; differences in the prevalence of AUDs among those who experienced physical abuse and multiple types of maltreatment were larger for the older age group. Finally, among those with AUDs, maltreatment was associated with specific perceived barriers to treatment. 

The current findings highlight childhood maltreatment, including emotional abuse and neglect, as important correlates of AUDs among emerging adults but indicate that these relationships may be accounted for by other psychiatric comorbidities. Barriers to treatment among individuals with AUDs may reflect maltreatment experiences and should be addressed in both policy and practice.

Read Full Abstract

Request Reprint E-Mail:    abbyl.goldstein@utoronto.ca

Job Strain, Hazardous Drinking, and Alcohol-Related Disorders Among Brazilian Bank Workers

To assess the association between high job strain and drinking behaviors among bank workers.

 A cross-sectional study was performed in 1,080 Brazilian bank employees. Participants completed a self-reported questionnaire, including the Alcohol Use Disorders Identification Test to assess hazardous drinking (HZD). Alcohol-related disorders (ARDs) were assessed using the Composite International Diagnostic Interview. Associations between job strain and drinking behaviors were tested by fitting the main effects of high job demands and low job control, with the interaction between them, and by comparing high demands and low-control jobs with other jobs, using Poisson regression.

Prevalences of HZD and ARDs were 25.5% and 13.5%, respectively. For the association with HZD, there was a significant interaction between high demands and low control (prevalence ratio [PR] = 1.56, 95% CI [1.03, 2.35]). For low-demand jobs, low control was negatively associated with HZD (PR = 0.69, 95% CI [0.50, 0.97]). High demands only conferred increased risk for HZD in the context of low control. Patterns of association with ARDs were similar but did not reach statistical significance. Furthermore, multivariate analyses supported the associations between the four-quadrant job-strain model and HZD. However, passive jobs were associated with a low prevalence of HZD, and post hoc analysis suggested that increased risk of HZD was concentrated in the highest quarter of job strain (PR = 1.55, 95% CI [1.10, 2.21]).

High job strain was associated with HZD; the association with ARDs was equivocal. For HZD, an interaction between high demands and low control, as posited by Karasek, was observed.


Read Full Abstract
Request Reprint E-Mail:     c.lima@iop.kcl.ac.uk

Affective Cue-Induced Escalation of Alcohol Self-Administration and Increased 22-kHz Ultrasonic Vocalizations during Alcohol Withdrawal: Role of Kappa-Opioid Receptors

 

 

Negative affect promotes dysregulated alcohol consumption in non-dependent and alcohol-dependent animals, and cues associated with negative affective states induce withdrawal-like symptoms in rats.

This study was designed to test the hypotheses that: (1) the kappa-opioid receptor (KOR) system mediates phenotypes related to alcohol withdrawal and withdrawal-like negative affective states and (2) cues associated with negative affective states would result in dysregulated alcohol consumption when subsequently presented alone.

To accomplish these goals, intracerebroventricular infusion of the KOR antagonist nor-binaltorphimine (nor-BNI) was assessed for the ability to attenuate the increase in 22-kHz ultrasonic vocalizations (USVs) associated with alcohol withdrawal and KOR activation in adult male wistar rats. Furthermore, cues associated with a KOR agonist-induced negative affective state were assessed for the ability to dysregulate alcohol consumption and the efficacy of intracerebroventricular KOR antagonism to reduce such dysregulation was evaluated.

KOR antagonism blocked the increased number of 22-kHz USVs observed during acute alcohol withdrawal and a KOR agonist (U50,488) resulted in a nor-BNI reversible increase in 22-kHz USVs (mimicking an alcohol-dependent state). Additionally, cues associated with negative affective states resulted in escalated alcohol self-administration, an effect that was nor-BNI sensitive.

 

Taken together, this study implicates negative affective states induced by both alcohol withdrawal and conditioned stimuli as being produced, in part, by activity of the DYN/KOR system.

 

 

Read Full Abstract

 

Request Reprint E-Mail:    brendan.walker@wsu.edu

Chronic mild stress increases alcohol intake in mice with low dopamine D2 receptor levels.

Alcohol use disorders emerge from a complex interaction between environmental and genetic factors. Stress and dopamine D2 receptor levels (DRD2) have been shown to play a central role in alcoholism.

To better understand the interactions between DRD2 and stress in ethanol intake behavior, we subjected Drd2 wild-type (+/+), heterozygous (+/−), and knockout (−/−) mice to 4 weeks of chronic mild stress (CMS) and to an ethanol two-bottle choice during CMS weeks 2–4. Prior to and at the end of the experiment, the animals were tested in the forced swim and open field tests. We measured ethanol intake and preference, immobility in the force swim test, and activity in the open field. 

We show that under no CMS, Drd2+/− and Drd2−/− mice had lower ethanol intake and preference compared with Drd2+/+. Exposure to CMS decreased ethanol intake and preference in Drd2+/+ and increased them in Drd2+/− and Drd2−/− mice. At baseline, Drd2+/− and Drd2−/− mice had significantly lower activity in the open field than Drd2+/+, whereas no genotype differences were observed in the forced swim test. Exposure to CMS increased immobility during the forced swim test in Drd2+/− mice, but not in Drd2+/+ or Drd2−/− mice, and ethanol intake reversed this behavior. No changes were observed in open field test measures.

These findings suggest that in the presence of a stressful environment, low DRD2 levels are associated with increased ethanol intake and preference and that under this condition, increased ethanol consumption could be used as a strategy to alleviate negative mood.


Read Full Abstract

Request Reprint E-Mail:    thanos@bnl.gov.

Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication

To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative psychostimulant treatment over time, or both relate to substance use/SUD; and to compare substance use/SUD in the ADHD sample to the non-ADHD childhood classmate comparison group (n = 261).

Mixed-effects regression models with planned contrasts were used for all tests except the important cumulative stimulant treatment question, for which propensity score matching analysis was used.

The originally randomized treatment groups did not differ significantly on substance use/SUD by the 8-year follow-up or earlier (mean age = 17 years). Neither medication at follow-up (mostly stimulants) nor cumulative stimulant treatment was associated with adolescent substance use/SUD. Substance use at all time points, including use of two or more substances and SUD, were each greater in the ADHD than in the non-ADHD samples, regardless of sex.

Medication for ADHD did not protect from, or contribute to, visible risk of substance use or SUD by adolescence, whether analyzed as randomized treatment assignment in childhood, as medication at follow-up, or as cumulative stimulant treatment over an 8-year follow-up from childhood. These results suggest the need to identify alternative or adjunctive adolescent-focused approaches to substance abuse prevention and treatment for boys and girls with ADHD, especially given their increased risk for use and abuse of multiple substances that is not improved with stimulant medication.


Read Full Abstract

Request Reprint E-Mail:    molinab@upmc.edu

Alcohol Policy 16 Conference - Preliminary Agenda

We anticipate offering these pre-conference institutes, plenary, major, and concurrent sessions (posters, workshops, and panels) thanks to presenters from Africa, Asia, Europe, North America, Oceania, and South America and will publish the final version in early April. > > > >  Read More

Patterns of Alcohol Use and Expectancies Predict Sexual Risk Taking Among Non–Problem Drinking Women

Although alcohol consumption and sexual risk taking are associated, not everyone who drinks alcohol engages in risky sexual behavior. The purposes of the present study were to identify patterns of alcohol use behaviors and alcohol expectancies among women who are non–problem drinkers and to examine how these patterns are associated with indices of sexual risk. 

Data from 758 non–problem drinking women who have sex with men and were not in committed relationships were analyzed using latent profile analysis to determine patterns of alcohol use and alcohol-related expectancies. 

Of the four patterns observed, three classes had similar alcohol-related expectancies but differed with respect to drinking behavior (moderate drinking, regular heavy episodes, and frequent heavy episodes), and the fourth class consisted of moderate drinkers with low expectancies (low expectancies). Results revealed that those in the frequent heavy episodes class had the greatest number of sexual partners in the past year and drank the most alcohol before having sex compared with the other women. Both the regular and frequent heavy episodes classes reported greater likelihood of having unprotected sex in the future, more positive beliefs about casual sex, and greater subjective intoxication before having sex than women in the moderate drinking or low expectancies classes. Women in the low expectancies class reported less positive beliefs about condoms than those in the moderate drinking and regular heavy episodes classes. 

Results suggest that different patterns of expectancies and drinking behaviors are associated with different indices of sexual risk taking and highlight the importance of individually tailored programs for prevention of sexually transmitted infections.


Read Full Abstract

Request Reprint E-Mail:    cstappen@uw.edu.

Genetic Variation in the Alpha Synuclein Gene (SNCA) Is Associated With BOLD Response to Alcohol Cues

Preclinical studies implicate the gene encoding the alpha synuclein protein (SNCA) in the pathophysiology of alcohol dependence and dopamine neuron function. Results from clinical studies are less conclusive. Using neurobiological phenotypes in genetic studies, rather than typical heterogeneous diagnostic categories derived from self-report, may improve reliability across studies. This study aimed to examine whether polymorphisms in the SNCA gene were associated with alcohol taste cue–elicited responses in the brain, one such intermediate phenotype. 

A total of 326 heavy drinkers who underwent an alcohol taste task during functional magnetic resonance imaging (fMRI) also were genotyped. Analyses focused on two previously identified SNCA variants (rs2583985 and rs356168) as well as 27 other single nucleotide polymorphisms from the Illumina Human1M BeadChip that were used in an exploratory analysis of the whole gene. Neurobiological phenotypes were defined as fMRI blood oxygenation level–dependent (BOLD) responses to alcohol taste cue (vs. a control cue) in seven regions of interest known to be involved in cue processing and rich in dopaminergic axon terminals. 

Polymorphisms in the SNCA gene were significantly correlated with BOLD activation. Specifically, the largest effect sizes and significance were seen for rs2583985 in paracingulate and caudate (focused analysis) and for rs1372522 in paracingulate (exploratory analysis). Activation in all regions of interest was correlated with alcohol-dependence severity. 

SNCA genotype was found to be associated with the degree of fMRI BOLD response during exposure to the taste of alcohol versus a control taste. This study also further validates the use of this alcohol taste task as an intermediate phenotype for alcohol-dependence severity.


Read Full Abstract

Request Reprint E-Mail:    cewilcox@salud.unm.edu

Effects of Memantine on Event-Related Potential, Oscillations, and Complexity in Individuals With and Without Family Histories of Alcoholism

Enhanced N-methyl-D-aspartate (NMDA) receptor function associated with a positive family history of alcoholism (FHP) has been hypothesized to contribute to the heritable risk for alcoholism. The objective of this study was to evaluate the relationship of alcoholism family history, NMDA receptor function, and cortical information processing by testing acute effects of the NMDA receptor antagonist memantine on event-related potential (ERP). 

Twenty-two healthy FHP and 20 healthy family history–negative (FHN; no alcoholic relatives) subjects were administered placebo or 40 mg of memantine under double-blind counterbalanced conditions on two separate occasions. Electroencephalogram data were collected from eight channels with eyes open during an auditory oddball discrimination task. We evaluated P3b amplitude, total theta, alpha activity, and fractal dimension from ERP trials. 

FHP and FHN subjects did not differ in P3b amplitude. A significant Group × Drug interaction was observed in theta, alpha activity, and fractal dimension at the parietal and occipital sites. FHP individuals exhibited significantly higher fractal dimension and lower theta and alpha activity after placebo relative to FHN subjects. Following memantine administration, theta activity decreased in both groups but more markedly for FHN individuals. Alpha activity decreased for FHN subjects and increased for FHP individuals, whereas the fractal dimension decreased for FHP subjects and increased for FHN subjects after memantine.

A plausible interpretation of these results is that FHP individuals may have altered NMDA receptor function compared with FHN individuals. These findings provide additional evidence of differences in the regulation of NMDA receptor function between FHP and FHN individuals. 


Read Full Abstract

Request Reprint E-Mail:   msteven@harthosp.org

Disparities in Access to Physicians and Medications for the Treatment of Substance Use Disorders Between Publicly and Privately Funded Treatment Programs in the United States

Prior research suggests that publicly funded substance use disorder (SUD) treatment programs lag behind privately funded programs in adoption of evidence-based practices, resulting in disparities in access to high-quality SUD treatment. These disparities highlight a critical public health concern because the majority of SUD patients in the United States are treated in the publicly funded treatment sector. This study uses recent data to examine disparities in access to physicians and availability of medications for the treatment of SUDs between publicly and privately funded SUD treatment programs. 

Data were collected from 595 specialty SUD treatment programs from 2007 to 2010 via face-to-face interviews, mailed surveys, and telephone interviews with treatment program administrators. 

Publicly funded programs were less likely than privately funded programs to have a physician on staff, even after controlling for several organizational characteristics that were associated with access to physicians. The results of negative binomial regression indicated that, even after taking into account physician access and other organizational variables, publicly funded programs prescribed fewer SUD medications than privately funded SUD treatment programs. 

Patients seeking treatment in publicly funded treatment programs continue to face disparities in access to high-quality SUD treatment that supports patients' choices among a range of medication options. However, implementation of the Affordable Care Act may facilitate greater access to physicians and use of medications in publicly funded SUD treatment programs. 


Read Full Abstract

Request Reprint E-Mail:    aabraham@uga.edu

Risky Alcohol Use and Serum Aminotransferase Levels in HIV-Infected Adults With and Without Hepatitis C

The purpose of this study was to examine the association between risky drinking amounts and serum aminotransferase levels in HIV-infected adults with and without hepatitis C virus (HCV) infection. 

In a prospective cohort of HIV-infected adults with current or past alcohol problems, we assessed whether drinking risky amounts (as defined by the National Institute on Alcohol Abuse and Alcoholism) was associated with higher levels of serum aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) over time, stratifying analyses by HCV status. Generalized linear mixed effects regression models were used to examine the association between risky drinking and natural log-transformed AST and ALT over time.

Among HIV/HCV–coinfected persons (n = 200), risky drinking was associated with a higher adjusted mean AST (62.2 vs. 51.4 U/L; adjusted ratio of means 1.2, 95% CI [1.07, 1.37], p = .003) and ALT (51.3 vs. 41.6 U/L; adjusted ratio of means 1.2, 95% CI [1.07, 1.42], p = .004) compared with non–risky drinking. In contrast, among HIV-infected adults without HCV infection (n = 197), there were no significant differences between those who did and did not drink risky amounts in AST (34.7 vs. 33.3 U/L; adjusted ratio of means = 1.0, 95% CI [0.95, 1.14], p = .36) or ALT (29.1 vs. 28.7 U/L; adjusted ratio of means = 1.0, 95% CI [0.91, 1.13], p = .78).

Among HIV-infected adults with HCV, those who drink risky amounts have higher serum aminotransferase levels than those who do not drink risky amounts. These results suggest that drinking risky amounts may be particularly harmful in HIV/HCV–coinfected adults and supports recommendations that providers pay special attention to drinking in this population. 


Read Full Abstract

Request Reprint E-Mail:    judith.tsui@bmc.org

Relationships Among Independent Major Depressions, Alcohol Use, and Other Substance Use and Related Problems Over 30 Years in 397 Families

Although heavy drinking is related to sadness on multiple levels, the link between alcohol use disorders (AUDs) and major depressive episodes (MDEs) is more controversial. One complicating factor is that some MDEs are temporary and only occur in the context of heavy drinking, whereas other MDEs are longer lasting and occur independently of intense alcohol intake (i.e., independent depressive episodes [IDEs]). We hypothesized that a longitudinal study that uses validated interviews with subjects and relatives and distinguishes between IDEs and alcohol-induced depressive episodes would reveal little evidence of a link between IDEs and AUDs. 

Histories of AUDs, IDEs, and substance-induced depressions were prospectively evaluated over 30 years in 397 male probands from the San Diego Prospective Study and in their 449 offspring using questions extracted from the Semi-Structured Assessment for the Genetics of Alcoholism interview. 

The rate of IDEs over 30 years in the 397 probands was 15.3% overall. Among probands who developed AUDs, 31% of their depressive episodes were substance induced, not IDEs. For these men followed over 3 decades, those with IDEs had no increased rate of AUDs and evidenced no higher rate of use or abuse/dependence on illicit substances. Similar conclusions applied to their 449 offspring ages 12 years and older. 

These data support the importance of uishing between IDE and substance-induced depressions when evaluating the relationship between AUDs and depression syndromes.

Read Full Article   (PDF)

Group Influences on Individuals' Drinking and Other Drug Use at Clubs

This article examines effects of the social group on individual alcohol and drug use upon entry and exit from the club. Based on collected biological measurements of alcohol and other drug use, this study explores whether social group indicators (e.g., group characteristics) are predictive of alcohol and other drug use for individual club patrons.

A total of 368 social groups, representing 986 individuals (50.7% female), were anonymously surveyed, and biological measures of alcohol and other drug use were collected at entrance and exit to clubs on a single evening. Both individual and group-level indicators were assessed. Because data were clustered by club, event, and group, mixed-model regressions were conducted to account for non-independence. 

Group indicators of high blood alcohol concentration were being in a group that intends to get drunk, that has at least one member who regularly gets drunk, and that has discrepancies in its expectations regarding drug use. Group indicators related to cocaine use were high levels of drug use expected among group members, little discrepancy among the group members regarding the drug use expected, and high levels of intentions to get drunk. In addition, older groups were more likely to have higher levels of cocaine use. There were less consistent findings regarding group effects on marijuana use. The most consistent finding was that high drug use expectations were related to higher levels of marijuana use. 

Together, these data suggest that strategies should focus on recognizing group indicators as risks for group members. Promoting social responsibility for group members may create safer club experiences among young adults. These efforts could model designated-driver programs as a way to increase safety and social responsibility.


Read Full Abstract

Request Reprint E-Mail:    bmiller@prev.org

Where and When Adolescents Use Tobacco, Alcohol, and Marijuana: Comparisons by Age, Gender, and Race

This study examined the location and time of adolescent use of cigarettes, alcohol, and marijuana. Age, gender, and racial differences in location and time of use were studied for each substance. 

Using cross-sectional data collected through the school-wide Pride Survey, 20,055 students between the ages of 10 and 19 years (53.6% female, 55.1% Black, 44.9% White) in one metropolitan area reported on their frequency of cigarette, alcohol, and marijuana use, as well as the location and time of use of each substance. Chi-square tests compared the rates, locations, and times for each substance across boys and girls; Black and White students; and early, middle, and late adolescents. 

Older adolescents reported higher rates of substance use at friends' homes, at school, and in cars and lower rates of alcohol use at home compared with younger youth. Males were more likely to report alcohol and marijuana use at school and on weeknights and alcohol use in cars, whereas females were more likely to report alcohol and marijuana use on the weekends. No gender differences emerged for times and locations of cigarette use. Compared with Black youth, White adolescents were more likely to use all substances at friends' homes and on weekends; to smoke cigarettes at school, in the car, and on weeknights; and to use alcohol at home. Black adolescents were more likely to report using alcohol at home, at school, in cars, during and after school, and on weeknights and were more likely to report using marijuana at school. 

The location and time of adolescent substance use vary substantially by age, gender, and race. These differences may help tailor substance use prevention and intervention programs to specific subgroups of youth to improve program effectiveness.


Read Full Abstract

Request Reprint E-Mail:   egoncy@vcu.edu

Effectiveness of a Tailored Goal Oriented Community Brief Intervention (TGCBI) in Reducing Alcohol Consumption Among Risky Drinkers in Thailand: A Quasi-Experimental Study

An intervention to reduce the average alcohol intake and the number of drinking days in risky drinkers was conducted in a quasi-experimental study in two communities (intervention and control communities) in Lop Buri Province, Thailand. 

The participants were risky drinkers (with scores ranging from 8 through 19 on the World Health Organization's Alcohol Use and Disorders Identification Test) ages 19–65 years. In the intervention community, individual participants set their own drinking-reduction goals, and each participant received a Tailored Goal Oriented Community Brief Intervention (TGCBI) administered in four sessions over 2 months. The number of drinking days and the average alcohol intake during the past 30 days were measured before the intervention and at 1, 3, and 6 months after it. Complete data were available from 47 intervention and 50 control participants. Intervention effects at each post-intervention time were assessed with linear mixed models. 

Baseline sociodemographic characteristics showed no statistically significant differences between the two groups (p > .05). At baseline, M (SD) days of drinking and average daily alcohol intake were 12.9 days (10.5) and 20.4 g (19.2), respectively. The intervention was associated with a substantial reduction in both measures at each post-intervention time, and magnitudes of reduction increased with increasing time. Modeled intervention-related reductions in drinking days at successive post-intervention times were 5.1 (p = .031), 7.4 (p = .001), and 9.0 days (p < .001). Corresponding reductions in daily alcohol intake were 16.5, 17.4, and 25.0 g (p < .001 at 1 month, 3 months, and 6 months, respectively, after the intervention). Adjustment for potential confounders and inclusion in the analysis of participants with missing data made little difference in modeled intervention effects. 

TGCBI was associated with a substantial and significant reduction in drinking days and average alcohol intake through 6 months after the intervention. TGCBI could well prove beneficial for risky drinkers both inside and outside Thailand. 


Read Full Abstract 

Request Reprint E-Mail:    Chitlada.A@chula.ac.th

Alcoholism and Timing of Separation in Parents: Findings in a Midwestern Birth Cohort

We examined history of alcoholism and occurrence and timing of separation in parents of a female twin cohort. 

 Parental separation (never-together; never-married cohabitants who separated; married who separated) was predicted from maternal and paternal alcoholism in 326 African ancestry (AA) and 1,849 European/ other ancestry (EA) families. Broad (single-informant, reported in abstract) and narrow (self-report or two-informant) measures of alcoholism were compared. 

Parental separation was more common in families with parental alcoholism: By the time twins were 18 years of age, parents had separated in only 24% of EA families in which neither parent was alcoholic, contrasted with 58% of families in which only the father was (father-only), 61% of families in which only the mother was (mother-only), and 75% in which both parents were alcoholic (two-parent); corresponding AA percentages were 59%, 71%, 82%, and 86%, respectively. Maternal alcoholism was more common in EA never-together couples (mother-only: odds ratio [OR] = 5.95; two parent: OR = 3.69). In ever-together couples, alcoholism in either parent predicted elevated risk of separation, with half of EA relationships ending in separation within 12 years of twins' birth for father-only families, 9 years for mother-only families, and 4 years for both parents alcoholic; corresponding median survival times for AA couples were 9, 4, and 2 years, respectively. EA maternal alcoholism was especially strongly associated with separation in the early postnatal years (mother-only: birth–5 years, hazard ratio [HR] = 4.43; 6 years on, HR = 2.52; two-parent: HRs = 5.76, 3.68, respectively). 

Parental separation is a childhood environmental exposure that is more common in children of alcoholics, with timing of separation highly dependent on alcoholic parent gender. 


Read Full Abstract

Request Reprint E-Mail:   mwaldron@indiana.edu

Examining Alcohol and Alcohol-Free Versions of a Simulated Drinking Game Procedure

Drinking games contribute to heavy drinking on college campuses because the rules often result in rapid alcohol consumption and increased risk of negative consequences. The current study used the Simulated Drinking Game Procedure (SDGP) to observe and describe drinking game behavior under controlled laboratory conditions. 

Participants (N = 40) age of 21 and older played a laboratory version of beer pong. Participants were randomly assigned to play with either beer or water, and the study examined the differences in consumption, blood alcohol concentration (BAC) estimates, and subjective experiences within and across the beverage conditions. 

Participants in both beverage conditions viewed the sessions as realistic simulations of actual drinking games. Participants who played with beer consumed more drinks and refused fewer drinks than those served water. Two measures of BAC (calculated formula and breath alcohol device) were correlated with one another and with the amount of alcohol consumed. BAC estimates based on the formula tended to be higher than readings obtained from the breath alcohol device, and the discrepancies between the two measures were higher among female participants. 

The findings suggest that both the alcohol and alcohol-free versions of the SDGP are safe and ecologically valid research tools for examining drinking game behavior. The study highlights the features and limitations of both versions of the SDGP and provides a platform for continued development of the methodology, allowing researchers to address a range of clinically relevant research questions. 


Read Full Abstract

Request Reprint E-Mail:   mms0016@auburn.edu

Effects of early postnatal alcohol exposure on the developing retinogeniculate projections in C57BL/6 mice

Previous studies on the adverse effects of perinatal exposure to ethanol (EtOH) on the developing visual system mainly focused on retinal and optic nerve morphology.

The aim of the present study was to investigate whether earlier reported retinal and optic nerve changes are accompanied by anomalies in eye-specific fiber segregation in the dorsal lateral geniculate nucleus (dLGN). 

C57BL/6 mice pups were exposed to ethanol by intragastric intubation at either 3 or 4 g/kg from postnatal days (PD) 3–10, the third trimester equivalent to human gestation. Control (C) and intubation control (IC) groups not exposed to ethanol were included. On PD9, retinogeniculate projections were labeled by intraocular microinjections of cholera toxin-β (CTB) either conjugated to Alexa 488 (green) or 594 (red) administrated to the left and right eye, respectively. Pups were sacrificed 24 h after the last CTB injection. 

The results showed that ethanol exposure decreased the total number of dLGN neurons and significantly reduced the total dLGN projection as well as the contralateral and ipsilateral projection areas.


Read Full Abstract

Request Reprint E-Mail:    rfberman@ucdavis.edu

Concern over alcohol industry conflict of interest

An independent coalition of public health professionals, health scientists and NGO representatives has written a public letter that is addressed to the WHO Director General in response to the recent initiatives of the global alcohol producers. Individuals and organizations are invited to sign on to the statement.  > > > >  Read More