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

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


Saturday, March 23, 2013

Replication of Genome Wide Association Studies of Alcohol Dependence: Support for Association with Variation in ADH1C

Genome-wide association studies (GWAS) have revealed many single nucleotide polymorphisms (SNPs) associated with complex traits. Although these studies frequently fail to identify statistically significant associations, the top association signals from GWAS may be enriched for true associations.

We therefore investigated the association of alcohol dependence with 43 SNPs selected from association signals in the first two published GWAS of alcoholism. Our analysis of 808 alcohol-dependent cases and 1,248 controls provided evidence of association of alcohol dependence with SNP rs1614972 in the ADH1C gene (unadjusted p = 0.0017). Because the GWAS study that originally reported association of alcohol dependence with this SNP
[1] included only men, we also performed analyses in sex-specific strata.

The results suggest that this SNP has a similar effect in both sexes (men: OR (95%CI) = 0.80 (0.66, 0.95); women: OR (95%CI) = 0.83 (0.66, 1.03)). We also observed marginal evidence of association of the rs1614972 minor allele with lower alcohol consumption in the non-alcoholic controls (p = 0.081), and independently in the alcohol-dependent cases (p = 0.046).

Despite a number of potential differences between the samples investigated by the prior GWAS and the current study, data presented here provide additional support for the association of SNP rs1614972 in ADH1C with alcohol dependence and extend this finding by demonstrating association with consumption levels in both non-alcoholic and alcohol-dependent populations.

Further studies should investigate the association of other polymorphisms in this gene with alcohol dependence and related alcohol-use phenotypes.

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Friday, March 22, 2013

Predictors of Alcohol Use Among Rural Drug Users After Disclosure of Hepatitis C Virus Status


Alcohol consumption dramatically increases the risk of liver damage among those with hepatitis C virus (HCV) infection, yet the impact of HCV status disclosure and standard informational counseling on alcohol use among rural drug users remains poorly understood.

In this prospective study, 503 rural Appalachian drug users were recruited using respondent-driven sampling. Participants were tested for HCV antibodies, and data on sociodemographic characteristics, lifetime and past-30-day drug and alcohol use, and psychiatric disorders were collected by interviewer-administered questionnaires. A total of 470 participants returned after 6 months for follow-up; however,4 of those had no history of alcohol use, thus leaving a final sample size of 466. Multivariate negative binomial regression was used to determine the effect of disclosure of HCV status and posttest counseling on alcohol consumption at follow-up.

Despite an overall decrease in drinking frequency in the cohort, those who were HCV-positive were drinking at a frequency similar to their HCV-negative counterparts at follow-up, despite posttest counseling informing them of the risks of alcohol use with an HCV diagnosis (adjusted incidence rate ratio = 1.07, 95% CI [0.72, 1.61]). Significant predictors of increased days of alcohol use after 6 months included baseline alcohol use, baseline marijuana use, and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for antisocial personality disorder. Those using OxyContin at baseline had significantly fewer days of alcohol use at follow-up.

HCV status disclosure and standard informational counseling alone do not curtail drinking among HCV-positive drug users in the rural setting. Targeted interventions with regard to alcohol use are warranted in order to mitigate the damage of the HCV epidemic.

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Stimulant Use, Religiosity, and the Odds of Developing or Maintaining an Alcohol Use Disorder Over Time


Little is known about whether cocaine or methamphetamine use, particularly among stimulant users residing in rural areas, is associated with increased odds of developing or maintaining an alcohol use disorder (AUD) over time. One factor that may help to protect some users against the development of an AUD is religiosity. This study examined how stimulant use and religiosity are associated longitudinally with the odds of an AUD among a rural population-based cohort of stimulant users.

Recent stimulant users (N = 710) were recruited via respondent-driven sampling and were interviewed every 6 months over a 3-year period. Concurrent and lagged generalized estimating equations analyses were conducted to estimate how past-30-day crack cocaine, powder cocaine, and methamphetamine use; religiosity; and other covariates were associated with the odds of an AUD.

At baseline, 56% of the participants met AUD criteria. The odds of an AUD declined significantly over time in the concurrent, but not the lagged, model. Crack cocaine use was associated with increased odds of an AUD in both models, although the strength of the concurrent association between an AUD and crack cocaine use declined over time. Powder cocaine use and more frequent church attendance also were concurrently associated with decreased odds of an AUD.

Rural stimulant users, especially those using cocaine, could potentially benefit from treatment for both alcohol use and stimulant use. In addition, our findings suggest that greater frequency of church attendance may be related to lower odds of the development or maintenance of an AUD.

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Reliance on God, Prayer, and Religion Reduces Influence of Perceived Norms on Drinking

Previous research has shown that perceived social norms are among the strongest predictors of drinking among young adults. Research has also consistently found religiousness to be protective against risk and negative health behaviors. The present research evaluates the extent to which reliance on God, prayer, and religion moderates the association between perceived social norms and drinking.

Participants (n = 1,124 undergraduate students) completed a cross-sectional survey online, which included measures of perceived norms, religious values, and drinking. Perceived norms were assessed by asking participants their perceptions of typical student drinking. Drinking outcomes included drinks per week, drinking frequency, and typical quantity consumed.

Regression analyses indicated that religiousness and perceived norms had significant unique associations in opposite directions for all three drinking outcomes. Significant interactions were evident between religiousness and perceived norms in predicting drinks per week, frequency, and typical quantity. In each case, the interactions indicated weaker associations between norms and drinking among those who assigned greater importance to religiousness.

The extent of the relationship between perceived social norms and drinking was buffered by the degree to which students identified with religiousness. A growing body of literature has shown interventions including personalized feedback regarding social norms to be an effective strategy in reducing drinking among college students. The present research suggests that incorporating religious or spiritual values into student interventions may be a promising direction to pursue.

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Evaluating Alcoholics Anonymous's Effect on Drinking in Project MATCH Using Cross-Lagged Regression Panel Analysis

The objective of the study is to determine whether Alcoholics Anonymous (AA) participation leads to reduced drinking and problems related to drinking within Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), an existing national alcoholism treatment data set.

The method used is structural equation modeling of panel data with cross-lagged partial regression coefficients. The main advantage of this technique for the analysis of AA outcomes is that potential reciprocal causation between AA participation and drinking behavior can be explicitly modeled through the specification of finite causal lags.

For the outpatient subsample (n = 952), the results strongly support the hypothesis that AA attendance leads to increases in alcohol abstinence and reduces drinking/ problems, whereas a causal effect in the reverse direction is unsupported. For the aftercare subsample (n = 774), the results are not as clear but also suggest that AA attendance leads to better outcomes.

Although randomized controlled trials are the surest means of establishing causal relations between interventions and outcomes, such trials are rare in AA research for practical reasons. The current study successfully exploited the multiple data waves in Project MATCH to examine evidence of causality between AA participation and drinking outcomes.

The study obtained unique statistical results supporting the effectiveness of AA primarily in the context of primary outpatient treatment for alcoholism.

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Association of VMAT2 gene polymorphisms with alcohol dependence

Alcohol-related diseases cause significant harm in the western world. Up to 65 % of the phenotypic variance is genetically determined.

Few candidate genes have been identified, comprising ADH4, ALDH2, COMT, CRHR1, DAT (SLC6A3), GABRA2 and MAOA. While abnormalities in the dopaminergic mesolimbic reward system are considered important mediators of alcoholism, studies analyzing variants of dopamine receptors showed conflicting results.

Other modulators of the reward system are synaptosomal genes. Among candidate genes, polygenic variants of the Vesicular Monamine Transporter 2 (VMAT2) gene locus associated with alterations of drinking behavior were published. These variants comprise single nucleotide polymorphisms (SNPs) within the promoter region and the open reading frame.

In this study, we confirm the association of VMAT2 SNP rs363387 (allelic association: p = 0.015) with alcohol dependence. This SNP defines several haplotypes including up to four SNPs (minimal p = 0.0045). In addition, numeric effects in the subgroups of males and patients with positive family history were found.

We suggest that several rs363387 T-allele containing haplotypes increase the risk of alcohol dependence (OR 1.53), whereas G-allele containing haplotypes confer protection against alcohol dependence.

Taken together, there is supporting evidence for a contribution of VMAT2 gene variants to phenotypes of alcohol dependence.

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Decline in Past Month Alcohol Use Among U.S. 8th Graders Reaches Record Low; Decline Among 10th and 12th Graders May Have Stalled

The percentage of 8th graders reporting past month use of alcohol reached a record low† in 2012, according to data from the national Monitoring the Future study.

Approximately one-tenth (11%) of 8th graders reported drinking at least one sip of alcohol in the past month in 2012, compared to the peak prevalence of 26% in 1996. Past month prevalence rates among 10th and 12th graders reached record low levels in 2011, at 27% and 40%, respectively, but did not change significantly from 2011 to 2012 (see figure below).

The decline in use among 12th graders in this survey is similar to the decline in past year use reported by college freshmen (see CESAR FAX, Volume 22, Issue 9).   > > > >  Read More

Budget 2013: Beer duty sees small drop but wine and spirit duty esacalator remains

As of Sunday the price of a pint will be 1p less, ending the beer duty escalator that would have added 3p to a pint, as announced in the 2013 Budget. However the 2% above inflation duty rise continues for other drinks, adding 10p to a bottle of wine and 53p to a litre bottle of spirits.

Pub and beer groups heralded the news as a welcome boost to the flagging pub industry, which has seen 10,000 pubs closed in the last 10 years. Last year the Campaign for Real Ale (CAMRA) led on a petition calling for a freeze on duty, which achieved over 100,000k signatures and a parliamentary debate.   > > > >   Read More

Thursday, March 21, 2013

Patterns of use and motivations for consuming alcohol mixed with energy drinks.

Use of alcohol mixed with energy drinks (AmED) is an increasingly prevalent trend. However, recent research has suggested that AmED use may result in increased alcohol consumption and engagement in risk behavior postingestion. Although the majority of research has been focused on AmED use outcomes, there is a current paucity of data on the patterns of AmED use and motives for consumption.

Four hundred and three participants from an Australian community sample (n = 244 women) ages 18–35 who had consumed alcohol mixed simultaneously with energy drinks (ED) in the preceding 6 months completed an online survey regarding use of EDs, alcohol, and AmED.

Although AmED sessions occurred relatively infrequently compared to alcohol sessions, the alcohol and ED quantity consumed in AmED sessions was significantly greater than recommended intake. Reports of AmED use context indicated that participants typically consumed AmED while engaging in heavy drinking in public venues. However, the primary motives for AmED use related to the situational context of use, functional and hedonistic outcomes, as well as the pleasurable taste; few participants reported using AmED to increase alcohol intake, to mask intoxication, to hide alcohol's flavor, or to simulate an illicit drug “high.”

AmED users may be coingesting in a context and at a quantity that enhances the possibility of risky alcohol outcomes, despite predominantly consuming AmED for the taste and the functional and hedonistic outcomes.

Strong endorsement of motives relating to ease of access and low cost price suggests that alcohol policy reform in relation to licensing restrictions may be necessary to minimize the risk of harm.

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Drinking motives and drinking behavior over time: A full cross-lagged panel study among adults.

Drinking motives are among the most proximal factors for drinking behavior and serve as a mechanism through which more distal factors are mediated. However, it is less clear whether drinking motives are precursors of drinking or, in contrast, shaped by previous drinking experiences (reciprocal effects), or both. Moreover, in adults it is unclear whether drinking motives, usually shaped in adolescence, influence each other over time.

In this longitudinal study (N = 2440, 47% women, average age 53 years), drinking motives and drinking behavior (i.e., number of drinks on the heaviest drinking day and number of drinking days; both during the past week) were assessed at 2 time points, separated by 3 months.

Full cross-lagged regression models revealed that drinking motives were positively associated with drinking behavior over time and that drinking motives are shaped by the number of drinking days (i.e., reciprocal effects).

Furthermore, coping and enhancement motives, as well as social and conformity motives, positively reinforced each other. Moreover, social motives were positively associated with enhancement motives over time. In conclusion, drinking motives influence each other over a 3-month period in adulthood and predict drinking behavior over time, making them important candidates for prevention efforts.

Drinking motives are likely to be modifiable and might be used to stimulate drinking decrease.

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Effects of alcohol on sequential information processing: Evidence for temporal myopia.

Alcohol Myopia Theory (AMT) posits that alcohol restricts the focus of attention, such that behaviors are determined only by highly salient environmental cues. While AMT is most commonly understood in terms of spatial attention, the present study tested the effects of alcohol in the temporal domain of attention.

Seventy-one participants consumed either a placebo beverage or one of two doses of alcohol (0.40g/kg or 0.80g/kg ETOH) before performing an auditory discrimination task while event-related potentials (ERPs) were recorded.

Consistent with typical sequential effects, placebo participants showed increased P300 amplitude and slowed behavioral responses when the current target differed from the two-back tone. In contrast, alcohol caused increased P300 and response slowing when the target tone differed from the one-back tone.

These findings suggest that alcohol increases the salience of more recently encountered information, consistent with the general tenets of AMT.

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Predictive effects of good self-control and poor regulation on alcohol-related outcomes: Do protective behavioral strategies mediate?


In the present study, we examined whether use of protective behavioral strategies mediated the relationship between self-control constructs and alcohol-related outcomes. According to the two-mode model of self-control, good self-control (planfulness; measured with Future Time Perspective, Problem Solving, and Self-Reinforcement) and poor regulation (impulsivity; measured with Present Time Perspective, Poor Delay of Gratification, Distractibility) are theorized to be relatively independent constructs rather than opposite ends of a single continuum.

The analytic sample consisted of 278 college student drinkers (68% women) who responded to a battery of surveys at a single time point. Using a structural equation model based on the two-mode model of self-control, we found that good self-control predicted increased use of three types of protective behavioral strategies (Manner of Drinking, Limiting/Stopping Drinking, and Serious Harm Reduction).

Poor regulation was unrelated to use of protective behavioral strategies, but had direct effects on alcohol use and alcohol problems. Further, protective behavioral strategies mediated the relationship between good self-control and alcohol use.
The clinical implications of these findings are discussed.

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tentional biases in abstinent alcoholics and their association with craving.

Previous investigations of attentional bias for alcohol cues in abstinent alcoholics indicate enhanced processing of alcohol cues on the modified Stroop task, and a more complicated “vigilance-avoidance” pattern of attentional bias on the visual probe task. Given that, in general, subjective craving is positively associated with attentional bias, we predicted that attentional biases in abstinent alcoholics would depend on their level of alcohol craving.

In the present study 28 alcoholic patients, who had recently commenced a day treatment program, and 26 social drinking controls completed an alcohol Stroop task, a visual probe task with three stimulus durations (200, 500, and 2,000 ms), and self-report assessments of craving and alcohol dependence.

On the alcohol Stroop task, abstinent alcoholics showed a greater interference effect for alcohol-related than neutral words, relative to social drinkers. On the visual probe task, alcoholic patients who reported a high level of craving exhibited a greater attentional bias toward alcohol cues, relative to both patients reporting a low level of craving, and social drinker controls. Alcoholics who reported low levels of craving showed avoidance of alcohol cues at 500 ms, relative to social drinkers. Among alcoholics, early dropout from treatment was associated with the severity of alcohol dependence and the strength of subjective craving, but it was not associated with measures of attentional bias.

These results clarify the importance of subjective craving as a correlate of attentional biases in abstinent alcoholics.

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The individualized alcohol Stroop task: No attentional bias toward personalized stimuli in alcohol-dependents.

This study aimed to investigate attentional bias in alcohol-dependent patients and control participants with regard to individualized (specific) and nonindividualized (general) alcohol-related words.

First, it was assumed that alcohol-dependents rather than control participants are more distracted by alcohol-related words, particularly individualized alcohol-related words, than by non–alcohol-related words.

Second, words which are derived from participants' individual drinking experiences were assumed to induce the highest Stroop interference over all participants.

Alcohol-dependent patients (Diagnostic and Statistical Manual of Mental Disorders IV, n = 39) and healthy control participants with a moderate consume of alcohol (n = 33) completed a modified alcohol Stroop task based on word stimuli derived from four categories: neutral versus negative and specific versus general alcohol-related words.

While alcohol-dependents showed similar RTs in the different word categories, control participants showed the slowest reactions after presentation of specific alcohol-related words. Generally, alcohol-dependents had slower RTs than controls did.

The results do not corroborate the hypothesis of increased interference caused by specific alcohol-related words in alcohol-dependents—instead, this presumption seems to apply to the control participants only. As we did not find any special impact of personally relevant alcohol-related words outclassing the influence of preselected alcohol-related words in the patient group, the benefit of individualized stimuli should be reconsidered.

Our results do not support the relevance of attentional retraining programs.

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Wednesday, March 20, 2013

Prospective changes in alcohol use among hazardous drinkers in the absence of treatment.


Gaining a better understanding of the natural course of hazardous alcohol consumption could inform the development of brief interventions to encourage self-change.
In the current study, hazardous drinkers (based on Alcohol Use Disorders Identification Test score) were recruited using advertisements to participate in a 2-year multiwave prospective study. Participants (n = 206) provided self-reports every six months during the study, including reports of daily alcohol consumption. The current investigation focuses on self-initiated change in participants' frequency of heavy drinking days (i.e., ≥ 5/4 drinks per day for men/women), as predicted by a number of demographic (e.g., age) and psychosocial (e.g., guilt-proneness) variables.
Latent growth curve models of the change in percent heavy drinking days over the 2-year period provided an excellent fit to the observed data and indicated a significant decline in percent heavy drinking days over time. Reductions in heavy drinking frequency were predicted by younger age and higher guilt-proneness.
The identification of these predictors of reductions in heavy drinking frequency provides information to guide future work investigating self-change among hazardous drinkers.
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A working memory bias for alcohol-related stimuli depends on drinking score.

We tested 44 participants with respect to their working memory (WM) performance on alcohol-related versus neutral visual stimuli. Previously an alcohol attentional bias (AAB) had been reported using these stimuli, where the attention of frequent drinkers was automatically drawn toward alcohol-related items (e.g., beer bottle).

The present study set out to provide evidence for an alcohol memory bias (AMB) that would persist over longer time-scales than the AAB. The WM task we used required memorizing 4 stimuli in their correct locations and a visual interference task was administered during a 4-sec delay interval. A subsequent probe required participants to indicate whether a stimulus was shown in the correct or incorrect location. For each participant we calculated a drinking score based on 3 items derived from the Alcohol Use Questionnaire, and we observed that higher scorers better remembered alcohol-related images compared with lower scorers, particularly when these were presented in their correct locations upon recall.

This provides first evidence for an AMB. It is important to highlight that this effect persisted over a 4-sec delay period including a visual interference task that erased iconic memories and diverted attention away from the encoded items, thus the AMB cannot be reduced to the previously reported AAB.

Our finding calls for further investigation of alcohol-related cognitive biases in WM, and we propose a preliminary model that may guide future research.

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Drinking initiation and problematic drinking among Latino adolescents: Explanations of the immigrant paradox.

Studies indicate that U.S.-born Latino teens exhibit higher rates of alcohol use compared with their foreign-born counterparts. Different hypotheses have been advanced to explain the mechanisms underlying this immigrant paradox, including the erosion of protective cultural factors across generations and increased exposure to risky peer environments in the United States.

The present study examined whether the immigrant paradox applies to drinking initiation and problematic drinking among Latino adolescents, and tested whether generational differences in family protective factors and peer risk factors might explain the immigrant paradox.

A nationally representative sample of Latino teens (N = 2,482) of Cuban, Mexican, and Puerto Rican origin from 3 immigrant generations (21% first generation, 33% second generation, and 46% third and later generations) was obtained from the National Longitudinal Study of Adolescent Health.

Logistic and negative binomial regression models indicated that early drinking initiation and problematic alcohol use were more prevalent among later-generation youth, supporting the immigrant paradox. Erosion of family closeness and increased association with substance-using peers mediated the relationship between generation and alcohol use patterns in this sample.

Results provide support for culturally sensitive interventions that target peer perceptions of substance use and bolster protective family values among Latino adolescents.

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I drink therefore I am: Validating alcohol-related implicit association tests.

There is an imperative to predict hazardous drinking among college students. Implicit measures have been useful in predicting unique variance in drinking and alcohol-related problems. However, they have been developed to test different theories of drinking and have rarely been directly compared with one another. Thus, their comparative utility is unclear.

The current study examined five alcohol-related variants of the Implicit Association Test (IAT) in a sample of 300 undergraduates and sought to establish their predictive validity.

Results indicated that the Drinking Identity IAT, which measured associations of “drinker” with “me,” was the most consistent predictor of alcohol consumption, alcohol problems, and alcohol cravings. It also had the highest internal consistency and test–retest reliability scores.

The results for the Alcohol Excitement and Alcohol Approach IATs were also promising, but their psychometric properties were less consistent. Although the two IATs were positively correlated with all of the drinking outcome variables, they did not consistently predict unique variance in those variables after controlling for explicit measures. They also had relatively lower internal consistencies and test–retest reliabilities.

Ultimately, results suggested that implicit drinking identity may be a useful tool for predicting alcohol consumption, problems, and cravings and a potential target for prevention and intervention efforts.

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Drinking buddies: Who are they and when do they matter?

The present study sought to further examine the role of peers on alcohol use and problems among young adults. In particular, we focused on a specific subset of peers in one's social network mostly for activities related to alcohol use called “drinking buddies.”
The presence of drinking buddies in one's social network has been shown to predict heavy drinking uniquely over time but few studies have focused on potential factors moderating the relationship. Consequently, an aim of present study was to examine the influence of drinking buddies on alcohol outcomes and the extent to which the relationship may be dependent on one's normative perceptions. Another aim was to provide a descriptive examination of drinking buddies.
Participants were college students (n = 250; 72.8% women) who completed self-report measures of alcohol use and problems, injunctive norms, descriptive norms and social network characteristics.

Results showed that descriptive norms moderated the relationship between drinking buddies and all alcohol outcomes assessed. Specifically, the influence of drinking buddies was stronger for those who perceived a lower prevalence of peer drinking. Examination of drinking buddies characteristics revealed that these peers tended to be young adults who were moderate social drinkers with whom they felt close and perceived to be available for concrete and emotional support. Several differences emerged between the drinking buddies of heavy versus non-heavy drinkers.
The present study contributed to the larger body of work on peer influence and alcohol use by examining a specific subgroup of peers that may promote risky drinking.

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Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services?

As both a concept and a movement, “recovery” is increasingly guiding substance use disorder (SUD) services and policy. One sign of this change is the emergence of recovery support services that attempt to help addicted individuals using a comprehensive continuing care model.

This paper reviews the policy environment surrounding recovery support services, the needs to which they should respond, and the status of current recovery support models.

We conclude that recovery support services (RSS) should be further assessed for effectiveness and cost-effectiveness, that greater efforts must be made to develop the RSS delivery workforce, and that RSS should capitalize on ongoing efforts to create a comprehensive, integrated and patient-centered health care system.

As the SUD treatment system undergoes its most important transformation in at least 40 years, recovery research and the lived experience of recovery from addiction should be central to reform.

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Conference 2013: Professor Jonathan Chick and Dr Jan Gill – A Tale of Two Cities

Professor Jonathan Chick and Dr Jan Gill discuss findings from their ongoing research into drinking behaviours in Glasgow and Edinburgh. Their research supports the evidence that those drinking at the most harmful levels purchase the cheapest alcohol – particularly white cider and cheap vodka. They conclude that minimum unit pricing is a targeted measure which would help tackle consumption among some of the most problematic drinkers.  > > > >  Read More

Conference 2013: Professor Paul Wallace and Stuart Linke: 10 Years of Down Your Drink

Professor Paul Wallace and Stuart Linke give an overview of the Down Your Drink online screening and brief advice website.

The presentation describes how the intervention has been amended over time, and presents feedback from a number of people who have used the site.  > > > >  Read More

Conference 2013: Professor Keith Humphreys and Baroness Finlay of Llandaff on Science and British Alcohol Policy

President Obama’s former drugs advisor, Professor Keith Humphreys, discusses the role of science in developing alcohol policy. Arguing that policy should be about values, not simply science, he presents three areas in which evidence can, nonetheless, strongly inform the debate. In particular, he calls for a swifter adoption of mandatory sobriety schemes, the expansion of treatment and recovery for dependent drinkers, and the introduction of minimum unit pricing.

Baroness Finlay of Llandaff has worked on many aspects of recent British alcohol policy. She also argues that the implementation of the 2012 Alcohol Strategy has been slow and more needs to be done to enforce existing legislation.

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Conference 2013: Dr David Foxcroft – Developmental Epidemiology and Prevention

Dr David Foxcroft discuss some of the latest research into alcohol education and prevention in schools, in particular the impact of programmes such as the Good Behaviour Game and the Strengthening Families programme. He suggests that community-oriented developmental prevention can have a significant impact on risk factors associated with drinking, but that we need a better understanding of how prevention effects are moderated by other factors such as gender.  > > > >  Read More

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.

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News and updates Mar 2013: minimum pricing plans in doubt; UK health bodies support 'statement of concern' over industry; other news

The Government has emphasised it is yet to confirm its
on minimum unit pricing (MUP) as Home Office minister Jeremy Brown said the Government were listening to "powerfull arguments on both sides" following the recent consultation. The Home Office website still states it "will introduce a minimum unit price for alcohol" - but for how long?
Last week fresh reports that the Prime Minister had u-turned on minimum unit pricing emerged, suggesting he had given in to pressure from a number of cabinet ministers. However speaking in the House of Commons, David Cameron insisted he was "determined" to deal with cheap alcohol. Health bodies urged the Government to stand firm on MUP.

Confirmation of whether MUP may come on Wednesday with the announcement of the budget. It has already been indicated that the alcohol duty escalator - increasing duty by 2% above inflation - is expected to be continued despite calls from pub and trade bodies to axe it.   > > > >  Read More

Monday, March 18, 2013

Commentary on Casswell (2013): The commercial determinants of health

Sally Casswell's paper
[1] highlights important differences between the ways in which the alcohol industry and tobacco industry are able to operate to promote their products and as a result limit government action aimed at reducing the harm that these products cause. Those of us in the field of tobacco research might wish to draw attention to the fact that in much of the world the tobacco industry still has considerable influence on government policy through either connivance with individuals within government by aggressive lobbying, or by litigation against governments that seek to implement policies which might reduce the industry's prodigious profits [2].
Nevertheless, Casswell is correct in asserting that the alcohol industry has an easier time of it; so does the food industry and the gambling industry. So, too, for that matter, does the oil industry, car manufacturers, diamond mining companies—and indeed, all those industries that provide goods or services that many people want, or can be induced to want. Unfortunately, the production and consumption of all these goods comes at a huge cost, including global health and climate change [3].  > > > >  Read More

Vested interests in addiction research and policy. Why do we not see the corporate interests of the alcohol industry as clearly as we see those of the tobacco industry?

To compare the current status of global alcohol corporations with tobacco in terms of their role in global governance and to document the process by which this difference has been achieved and the consequences for alcohol control policy.
Participant observation in the global political arena, review of industry materials (submissions, publications, conference presentations, websites) and review of published literature formed the basis for the current analysis.
Recent events in the global political arena have highlighted the difference in perception of the alcohol and tobacco industries which has allowed alcohol corporations to participate in the global governance arena in a way in which tobacco has not been able. The transnational producers of alcohol have waged a sophisticated and successful campaign during the past three decades, including sponsorship of intergovernmental events, funding of educational initiatives, research, publications and sponsoring sporting and cultural events. A key aspect has been the framing of arguments to undermine perceptions of the extent of alcohol-related harms to health by promoting ideas of a balance of benefits and harms. An emphasis on the heaviest drinkers has been used to promote the erroneous idea that ‘moderate’ drinkers experience no harm and a goal of alcohol policy should be to ensure they are unaffected by interventions. This leads to highly targeted interventions towards the heaviest drinkers rather than effective regulation of the alcohol market.
A sophisticated campaign by global alcohol corporations has promoted them as good corporate citizens and framed arguments with a focus on drinkers rather than the supply of alcohol. This has contributed to acceptance in the global governance arena dealing with policy development and implementation to an extent which is very different from tobacco. This approach, which obscures the contribution supply and marketing make to alcohol-related harm, has also contributed to failure by governments to adopt effective supply-side policies.

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Commentary on Dawson et al. (2013): Drink to your health? Maybe not

Hundreds of observational, epidemiological studies have found that moderate alcohol intake is associated with a lower risk of a range of health outcomes compared to alcohol abstention, but that risk increases with heavy drinking (a distribution commonly known as a ‘U-shaped’ or ‘J-shaped’ curve) [1]. Many researchers, clinicians and the lay public now accept as common knowledge that moderate drinking is beneficial to one's health [2], and the association is hypothesized to be due to biological effects on several systems, including reduced blood pressure, increased blood lipoproteins and oxidation of low-density lipoprotein (LDL) cholesterol, among other pathways [3, 4].
There are, however, methodological issues and data inconsistencies regarding the relation between alcohol intake and health that require further investigation before the case is closed on moderate drinking. Resolving these outstanding issues and inconsistencies is of substantial public health importance: many individuals are now consuming alcohol, typically red wine, as a prescriptive for better health. If the relation between moderate alcohol consumption and health is more artifactual than causal, then public health recommendations will need to be reconsidered.

The first issue raised by Dawson et al. [5], and documented in other studies as well, is the ‘sick quitter’ effect. Dawson et al. document that individuals with incident cardiovascular disease and those rating health as good/fair/poor (versus very good or excellent) at age 55+ were more likely to stop drinking, as well as individuals with liver disease at ages 18–34. Thus, when alcohol intake is measured at a single time-point, non-drinkers will constitute both former drinkers who quit due to poor health and life-time abstainers. Separating former drinkers from life-time abstainers in studies of the effects of alcohol consumption on mortality is thus essential. Indeed, a recent analysis that did this showed that the J-shaped curve disappeared after taking into account former drinkers who quit due to poor health and that the association between alcohol consumption and mortality changed to a simple monotonic function: greater levels of alcohol consumption are associated with higher mortality [6].  > > > >  Read More