ALCOHOL REPORTS: 4/14/13

Friday, April 19, 2013

A Selective Insular Perfusion Deficit Contributes to Compromised Salience Network Connectivity in Recovering Alcoholic Men

Alcoholism can disrupt neural synchrony between nodes of in
trinsic functional networks that are maximally active when resting relative to engaging in a task, the default mode network (DMN) pattern. Untested, however, are whether the DMN in alcoholics can rebound normally from the relatively depressed task state to the active resting state and whether local perfusion deficits could disrupt network synchrony when switching from conditions of rest to task to rest, thereby indicating a physiological mechanism of neural network adaptation capability.

Whole-brain, three-dimensional pulsed-continuous arterial spin labeling provided measurements of regional cerebral blood flow (CBF) in 12 alcoholics and 12 control subjects under three conditions: pretask rest, spatial working-memory task, and posttask rest.

With practice, alcoholics and control subjects achieved similar task accuracy and reaction times. Both groups exhibited a high-low-high pattern of perfusion levels in DMN regions during the rest-task-rest runs and the opposite pattern in posterior and cerebellar regions known to be associated with spatial working memory. Alcoholics showed selective differences from control subjects in the rest-task-rest CBF pattern in the anterior precuneus and CBF level in the insula, a hub of the salience network. Connectivity analysis identified activation synchrony from an insula seed to salience nodes (parietal, medial frontal, anterior cingulate cortices) in control subjects only.

We propose that attenuated insular CBF is a mechanism underlying compromised connectivity among salience network nodes. This local perfusion deficit in alcoholics has the potential to impair ability to switch from cognitive states of interoceptive cravings to cognitive control for curbing internal urges.

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Request Reprint E-Mail: edie@stanford.edu

Wednesday, April 17, 2013

Effect of neuromuscular electrical stimulation in glycogen muscle reserves because of ingestion of ethanol: a study in rats.

To evaluate the effects of alcoholic ingestion and neurostimulation on the muscle glycogen reserve, body weight, blood sugar, and weight of the soleus muscle.

Twenty male rats were distributed into four experimental groups (n=5), namely, Control, Ethanol, Electrostimulated, and Ethanol+Electrostimulated. The study lasted for 22 days. The groups submitted to the use of ethanol received the substance diluted in water, which was consumed during the entire experimental period. The groups that received electrostimulation, undersedationfor the procedure, had their left hind leg shaved, and the current was applied daily for 7 days, in 20-minute sessions. Next, after induced alcoholism and electrical stimulation in the corresponding groups, the animals were euthanized so that their muscles could be sent for glycogen analysis.

The Ethanol group displayed a lower body weight when compared to the Control and Electrostimulated groups; the Ethanol+Electrostimulated groups had a lower body weight compared to the Control and Electrostimulated groups, but were in a better situation when compared to the Ethanol group. As to glycogen capture, it was noted that the Ethanol group demonstrated resistance to blood glucose capture, whereas the Ethanol Electrostimulated group showed better capture than the other groups. As to muscle weight, it was observed that the Ethanol group had a lower weight than did the Controls, and that the Electrostimulated group weight greater when compared to the Control and Ethanol groups, respectively. On the other hand, the Ethanol+Electrostimulated groups showed no significant difference relative to the Controls, but had better results when compared to the Ethanol group.

Chronic exposure to alcohol showed a direct relationship with reduced muscle and body weight, and in glycogen capture and muscle reserves, besides favoring innumerous organic disorders, thus interfering in rehabilitation processes.

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Hyposensitivity to Gamma-Aminobutyric Acid in the Ventral Tegmental Area During Alcohol Withdrawal: Reversal by Histone Deacetylase Inhibitors

Putative dopaminergic (pDAergic) ventral tegmental area (VTA) neurons have an important role in alcohol addiction. Acute ethanol increases the activity of pDAergic neurons, and withdrawal from repeated ethanol administration produces a decreased sensitivity of pDAergic VTA neurons to GABA. Recent studies show that behavioral changes induced by chronic alcohol are reversed by inhibitors of histone deacetylases (HDACs). Whether HDAC-induced histone modifications regulate changes in GABA sensitivity of VTA pDAergic neurons during withdrawal is unknown.

Here, we investigated modulation of withdrawal-induced changes in GABA sensitivity of pDAergic VTA neurons by HDAC inhibitors (HDACi), and also measured the levels of HDAC2, histone (H3-K9) acetylation, and GABA-Aα1 receptor (GABA (A-α1) R) subunit in VTA during ethanol withdrawal.

Mice were injected intraperitoneally (ip) with either ethanol (3.5 g/kg) or saline twice daily for 3 weeks. In recordings from pDAergic VTA neurons in brain slices from ethanol-withdrawn mice, sensitivity to GABA (50–500 μM) was reduced. In brain slices from ethanol-withdrawn mice incubated with the HDACi SAHA (vorinostat) or trichostatin A (TSA) for 2 h, the hyposensitivity of pDAergic VTA neurons to GABA was significantly attenuated.

There was no effect of TSA or SAHA on GABA sensitivity of pDAergic VTA neurons from saline-treated mice. In addition, ethanol withdrawal was associated with an increase in levels of HDAC2 and a decrease in histone (H3-K9) acetylation and levels of GABA (A-α1) R subunits in the VTA.

Therefore, blockade of upregulation of HDAC2 by HDACi normalizes GABA hyposensitivity of pDAergic neurons developed during withdrawal after chronic ethanol treatment, which suggests the possibility that inhibition of HDACs can reverse ethanol-induced neuroadaptational changes in reward circuitry.

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Request Reprint E-Mail: mbrodie@uic.edu

Tuesday, April 16, 2013

A Longitudinal Study of Drinking and Depression as Predictors of Insomnia in Alcohol-Dependent Individuals.

Insomnia and depressive symptoms are common symptoms among alcohol-dependent (AD) patients.

AD individuals (N = 364) were assessed during 2004–2009 in the Midwestern United States at baseline and 6-month intervals with the Sleep Problems Questionnaire, Time-Line Follow-Back interview, and the depression subscale of the Brief Symptom Inventory. Hierarchical Linear Modeling was used to analyze the data in this longitudinal study.

When modeled separately, both quantity of drinking (p < .01) and depression (p < .001) predicted insomnia severity, controlling for time, age, and gender. Drinking also predicted depressive symptoms (p < .001), and its effect on insomnia was mediated by depression severity (p < .001).

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Request Reprint E-Mail: olena.zhabenko@gmail.com

Effects of alcohol on cardiovascular disease

Originally thought to be cardioprotective, the pendulum is now swinging against alcohol, with more deaths due to drinking than lives saved

Evidence for an increased risk of cardiovascular disease in heavy drinkers goes back to the mid-1970s. Later studies focused on whether moderate consumption was cardioprotective. In 1984 Michael Marmot summarized the evidence as showing moderate drinkers to be at lower risk, but said this could be due to the ‘sick quitter’ effect.¹ JL Richard coined the term ‘French paradox’ in 1987 when he proposed that French wine drinking habits might explain their low coronary mortality rate despite a diet rich in saturated fat.²

Subsequent epidemiological studies support the observation that as far as cardiovascular disease is concerned, and ischaemic heart disease in particular, non-drinkers at baseline have higher mortality and event rates than those who drink moderate amounts.

But there is controversy over whether alcohol has a causal protective effect. ‘Many studies don't differentiate between lifelong abstainers and those who have quit’, says epidemiologist Prof. David Leon (London, UK). ‘Quitting is often associated with health problems, [the argument being] that those people stopped drinking because of their health, not that their health is poor because they don't drink’. > > > Read More

A Comparison of Maternal Outcomes From an Alcohol, Tobacco, and Other Drug Prevention Program for Mothers Choosing an Intervention Versus Being Randomized

Self-determination theory and substantial r
research findings suggest that more desirable outcomes may occur when participants are able to choose their prevention or treatment interventions, as having a choice may lead to greater motivation and feelings of self-efficacy.

The present study examined the influence of having a choice of family-based prevention programs for youth alcohol, tobacco, and other drug use on mothers’ communication outcomes. Families (N = 496) were those with an 11- to 12-year-old enrolled in Kaiser Permanente medical centers at one of four locations.

Results from multivariate repeated measures analyses supported the importance of having a choice for improved communication outcomes. As compared with families who were randomly assigned to a program, those allowed to choose showed improved tobacco-specific and peer pressure communication, with marginally improved alcohol communication. No differences were found between the groups for general communication.

Results suggest that allowing mothers to participate in decisions about health-related interventions for their teens may lead to better outcomes.

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Request Reprint E-Mail: hbyrnes@prev.org

Frequency of Alcohol Use in Adolescence as a Marker for Subsequent Sexual Risk Behavior in Adulthood

Although a number of studies have demonstrated an association between alcohol use frequency and sexual risk behavior, few have used longitudinal data. This study examined alcohol use frequency in adolescence as a predictor of HIV sexual risk behavior in adulthood.

We collected data among 1,368 participants in Colorado. During adolescence (time 1), respondents were asked about the frequency of using alcohol during the previous 12 months. In adulthood (time 2), the same respondents were asked about their sexual risk behavior during the previous 12 months. Sexual risk behavior items were used to construct an index, which was categorized to indicate low-, medium-, and high-risk study participants. The relationship between alcohol use patterns and risky sexual behavior was modeled using ordinal regression.

Compared with individuals who drank no alcohol in the past 12 months at time 1, the odds of being in a higher risk group of sexual behavior as opposed to a lower one at time 2 were 1.56 (95% CI, 1.04–2.35) among those who drank 6–19 times. Similarly, the odds of being in a higher risk group relative to a lower one among those who drank ≥20 times or were 1.78 (95% CI, 1.05–3.02).

Alcohol use patterns in adolescence may be useful markers for programs that aim to prevent risky sexual behavior. Based on alcohol intake patterns, it may be possible to identify frequent alcohol users that need to be targeted with appropriate alcohol use and HIV risk reduction messages.

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Request Reprint E-Mail: maureen.muchimba@colorado.edu

Monday, April 15, 2013

Alcohol News - 15/2013

Xinhua - Alcohol, drugs cause low birth weight: Australian study

Women with drug or alcohol related mental disorders are up to four times more likely to have a low- birth weight baby, an Australian study revealed.

YLE.fi (Helsinki) - Yle: Government planning outright ban on public alcohol advertising

Government is considering an outright ban on public alcohol advertising, Yle reports. The ban would also affect advertisements in media such as radio and the social networking site Facebook . However ads would still be permitted in sports sponsorships and will remain visible in stadia and on sports gear.

Marketingblog.fi (Finland) - Finnish government says NO to alcohol advertising

According to a recent news from Helsingin Sanomat, a Finnish government is planning to ban all alcohol outdoor advertising. While this would sound a good and educational solution for any modern nation who has already took steps towards more healthier world, especially in Finland where excess alcohol usage is a common health problem, plans do not fit for everyone.

The Local (Sweden) - Alcohol seizures down despite tough new law

Despite the introduction of a new law strengthening the powers of customs officials, the number of seizures of alcohol ordered online has declined dramatically in 2013.

Daily Nation (Kenya) - Governors urged to curb alcohol abuse, insecurity

County governments in Central region have an uphill task of curbing insecurity and alcoholism. “Alcoholism is expected to pose a great challenge to the new leaders,” said outgoing Central Provincial Commissioner Japhter Rugut.

News-Medical.net (USA) - Report outlines role of health departments, community coalitions in regulating alcohol outlet density

Regulating alcohol outlet density, or the number of physical locations in which alcoholic beverages are available for purchase in a geographic area, is an effective strategy for reducing excessive alcohol consumption and associated harms.

Vibe Ghana (Ghana) - Check excessive alcohol ads on TV and radio

Reverend Joseph Bosomah, Acting Chairman of the Central Presbytery of the Presbyterian Church of Ghana, has expressed concern about the excessive alcohol ads on television and radio.

Telegraph.co.uk (UK) - Pubs demand minimum alcohol price

The heads of pubs, nightclubs and breweries are pleading with David Cameron to stick to his plans to introduce a mininum alcohol price.

Irish Times (Ireland) - Gastroenterologists call for action on cheap alcohol

The Irish Society of Gastroenterology has called on the Government to introduce a 1 per cent levy on alcohol advertising and sponsorship expenditure.

EPHA (EU) - Evening reception - alcohol & cancer: a report from the Royal College of Physicians & the Alcohol Health Alliance UK

The current EU framework in the area of alcohol - the EU Strategy to support Member States in reducing alcohol related harm - came to an end in 2012 but Europe still remains the world heaviest drinker.

Thanh Nien Daily (Vietnam) - HCMC gov’t rejects police proposal to limit alcohol trade

The Ho Chi Minh City municipal administration has rejected a suggestion made by its police to place limits on the trade of alcoholic drinks after 10 p.m. as an attempt to reduce traffic accidents.

News-Medical.net - Baylor University study shows acute dose of alcohol may cause greater impairment in elderly

An acute dose of alcohol may cause greater impairment in coordination, learning and memory in the elderly than in young people, according to a study by Baylor University.

Guardian (Russia) - The Last Man in Russia, and the Struggle to Save a Dying Nation by Oliver Bullough – review

If Russia is dying, Bullough suggests one doesn't have to look far to find the cause. Russians are literally drinking themselves to death. If Bullough is right, then the staggering figure of Boris Yeltsin is a more accurate symbol for the nation that Putin's gung-ho, karate black-belt.

Haringey Independent (UK) - Annual Health Report ‘Is Haringey over the limit?’ sets out Haringey Borough Council plans to tackle alcohol

A senior doctor says harm from alcohol is one of the biggest challenges facing the borough. This year’s Annual Health Report, entitled ‘Is Haringey over the limit?’, sets out how Haringey Borough Council plans to tackle drink-related harm in the borough.

Legalbrief (South Africa) - Alcohol adverts Bill will curb misuse, says Minister

Anti-alcohol organisations argue Health Minister Aaron Motsoaledi's announcement that a Bill restricting alcohol advertising is likely to be presented to the Cabinet this week is a step in the right direction to curb alcohol misuse, says a report in The Mercury.

Stuff.co.nz (New Zealand) - Teens avoid harm from relaxed booze laws

Lowering the drinking age to 18 has not led to more binge-drinking or alcohol-related road accidents among young people, researchers have found.

Times of India - Reduced alcohol intake cuts dependency

A potential new treatment for alcoholism called nalmefene has been found to be effective and safe for reducing alcohol consumption in alcohol dependent individuals.

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Dr. Chan will protect alcohol policy from industry

In a comment to an article in the British Medical Journal on 11 April 2013, Dr. Chan stated that the WHO global alcohol strategy stipulates that “member states have a primary responsibility for formulating, implementing, monitoring and evaluating public policies to reduce the harmful use of alcohol. The development of alcohol policies is the sole prerogative of national authorities. In the view of WHO, the alcohol industry has no role in the formulation of alcohol policies, which must be protected from distortion by commercial or vested interests.” > > > > Read More

Underage drinking: Prevalence and risk factors associated with drinking experiences among Argentinean children

The aim of this study was to describe the prevalence and predictors of alcohol drinking behavior in children.

Data were obtained from 367 children, aged 8–12 years (M = 10.44 years, SD = 1.21 years; 61.9% female) from the city of Córdoba, Argentina. Several scales were used to assess risk factors, including personality traits, alcohol expectancy (i.e., beliefs about the consequences of using alcohol), and perceived peer alcohol use, for alcohol drinking and alcohol drinking experiences. Hierarchical regression analysis was used to determine the contribution of multiple risk factors to the quantity of alcohol consumed.

The results showed that 58% of the children had tasted alcohol, and approximately one-third drank alcohol again after the first drinking experience. Twelve-year-old children had a significantly higher prevalence of tasting and drinking alcohol and a significantly greater frequency and quantity of alcohol consumed than younger children. Eighty percent of the children who liked alcohol during their first drinking experience reported that they drank alcohol again. Among the children who did not like alcohol during their first drinking experience, only 31% drank alcohol again.

Underage drinking usually occurred under adult supervision in family settings when parents or other relatives allowed them to drink or were aware of their children's drinking.

The hierarchical regression analysis showed that being older and male, having more peers that drink alcohol, having higher levels of extroversion, and having alcohol expectancy for social facilitation increased the risk for greater alcohol use. The final model explained 33% of the total variance.

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Request Reprint E-Mail: angepilatti@gmail.com

Beer Flavor Provokes Striatal Dopamine Release in Male Drinkers: Mediation by Family History of Alcoholism

Striatal dopamine (DA) is increased by virtually all drugs of abuse, including alcohol. However, drug-associated cues are also known to provoke striatal DA transmission- a phenomenon linked to the motivated behaviors associated with addiction. To our knowledge, no one has tested if alcohol’s classically-conditioned flavor cues, in the absence of a significant pharmacologic effect, are capable of eliciting striatal dopamine release in humans.
Employing positron emission tomography (PET), we hypothesized that beer’s flavor alone can reduce the binding potential of [¹¹C]raclopride (a reflection of striatal DA release) in the ventral striatum, relative to an appetitive flavor control.

Forty-nine men, ranging from social to heavy drinking, mean age 25, with a varied family history of alcoholism underwent two [¹¹C]raclopride PET scans: one while tasting beer, and one while tasting Gatorade®.

Relative to the control flavor of Gatorade, beer flavor significantly increased self-reported desire to drink, and reduced [¹¹C]raclopride binding potential, indicating that the alcohol-associated flavor cues induced dopamine release.

Binding potential reductions were strongest in subjects with first-degree alcoholic relatives. These results demonstrate that alcohol-conditioned flavor cues can provoke ventral striatal dopamine release absent significant pharmacologic effects, and that the response is strongest in subjects with a greater genetic risk for alcoholism.

Striatal DA responses to salient alcohol cues may thus be an inherited risk factor for alcoholism.

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Request Reprint E-Mail: dkareken@iupui.edu.

Latest Findings alcohol bulletins: Public Health framework reviewed; alcohol counsellor skills; text advice can work & more

Recent bulletins from the

drug and alcohol bank:
Public health objectives for England including drugs and alcohol

Sets out the structure and objectives of the public health system for England effective from April 2013 and how progress against these objectives will be measured, including addiction treatment completions, alcohol-related hospital admissions, and prisoners identified as needing treatment for alcohol/drug problems.
Seminal studies of the impact of alcohol counsellor skills and support
In the alcohol treatment world, arguably studies don’t get more important than these landmarks in the relatively scarce literature about what makes some alcohol counsellors, therapists and treatment services more effective than others

'Treatment-resistant' skid-row alcoholics react to organised empathy
Later to become founding director of the US National Institute on Alcohol Abuse and Alcoholism, in the late 1950s Dr Morris Chafetz of Massachusetts General Hospital conducted a remarkable series of studies which proved that an alcohol clinic's intake and performance can be transformed by the simple application of empathy and organisation.

Post-emergency visit text message advice moderates drinking
For the first time this US study tried mobile phone text messaging as a way to monitor and moderate the hazardous drinking of young adults screened at emergency departments. Compared to merely monitoring, text-based advice did cut drinking – but why did monitoring-only patients actually start to drink more?

Nurse-led hepatitis education cost-effective way to curb drinking in methadone patients
At Californian methadone clinics, group education sessions led by a nurse and focused on the risks of aggravating hepatitis infection led to the same substantial reductions in drinking as one-to-one or group motivational interviewing conducted by highly trained counsellors, offering a cost-effective means to reduce alcohol-related risks.

Commentary on Maclennan et al. (2013): Evolution of local alcohol policy research. What's next?

Alcohol control advocates, policymakers and researchers in several countries have discovered—or, perhaps, rediscovered—local policy. For example, in the United States, the Community Preventive Services Task Force’s Guide to Community Preventive Services (the ‘Community Guide’) recommends a number of interventions that, in at least some jurisdictions, can be put into place by enacting—or preventing the reversal of—local policy.

These include maintaining limits on days and hours of sale, regulation of alcohol outlet density and preventing privatization of retail alcohol sales [1]. Other local policies, such as social host ordinances, have diffused widely in the United States, although there is not yet a scientific evidence base supporting their effectiveness [2]. Maclennan and colleagues offer an important contribution towards establishing a better understanding of local
alcohol policy development by presenting case studies from the experiences in three New Zealand communities [3]. > > > > Read More

Vested Interests in Addiction Research and Policy. Alliance between tobacco and alcohol industries to shape public policy

The tobacco and alcohol industries share common policy goals when facing regulation, opposing policies such as tax increases and advertising restrictions. The collaboration between these two industries in the tobacco policy arena is unknown. This study explored if tobacco and alcohol companies built alliances to influence tobacco legislation and, if so, how those alliances worked.

Analysis of previously secret tobacco industry documents.

In the early 1980s, tobacco companies started efforts to build coalitions with alcohol and other industries to oppose cigarette excise taxes, clean indoor air policies and tobacco advertising and promotion constraints. Alcohol companies were often identified as a key partner and source of financial support for the coalitions. These coalitions had variable success interfering with tobacco control policy-making.

The combined resources of tobacco and alcohol companies may have affected tobacco control legislation. These alliances helped to create the perception that there is a broader base of opposition to tobacco control. Advocates should be aware of the covert alliances between tobacco, alcohol and other industries and expose them to correct this misperception.

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Request Reprint E-Mail: pling@medicine.ucsf.edu

Population-Based Input Function Modeling for [(18)F]FMPEP-d 2, an Inverse Agonist Radioligand for Cannabinoid CB1 Receptors: Validation in Clinical Studies.

Population-based input function (PBIF) may be a valid alternative to full blood sampling for quantitative PET imaging. PBIF is typically validated by comparing its quantification results with those obtained via arterial sampling. However, for PBIF to be employed in actual clinical research studies, its ability to faithfully capture the whole spectrum of results must be assessed. The present study validated a PBIF for [¹⁸F]FMPEP-d₂, a cannabinoid CB₁ receptor radioligand, in healthy volunteers, and also attempted to utilize PBIF to replicate three previously published clinical studies in which the input function was acquired with arterial sampling.

The PBIF was first created and validated with data from 42 healthy volunteers. This PBIF was used to assess the retest variability of [¹⁸F]FMPEP-d₂, and then to quantify CB₁ receptors in alcoholic patients (n = 18) and chronic daily cannabis smokers (n = 29). Both groups were scanned at baseline and after 2–4 weeks of monitored drug abstinence.

PBIF yielded accurate results in the 42 healthy subjects (average Logan-distribution volume (V_T) was 13.3±3.8 mL/cm³ for full sampling and 13.2±3.8 mL/cm³ for PBIF; R² = 0.8765,) and test-retest results were comparable to those obtained with full sampling (variability: 16%; intraclass correlation coefficient: 0.89). PBIF accurately replicated the alcoholism study, showing a widespread ~20% reduction of CB₁ receptors in alcoholic subjects, without significant change after abstinence. However, a small PBIF-V_T bias of −9% was unexpectedly observed in cannabis smokers. This bias led to substantial errors, including a V_T decrease in regions that had shown no downregulation in the full input function. Simulated data showed that the original findings could only have been replicated with a PBIF bias between −6% and +4%.

Despite being initially well validated in healthy subjects, PBIF may misrepresent clinical protocol results and be a source of variability between different studies and institutions.

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Long lasting alterations to DNA methylation and ncRNAs may underlie the effects of fetal alcohol exposure

Fetal Alcohol Spectrum Disorders (FASD) are characterized by life long changes in gene expression, neurodevelopment, and behavior. What mechanisms initiate and maintain these changes are not known, but current research suggests a role for alcohol induced epigenetic changes.

In this report we assessed alterations to adult mouse brain tissue by assaying DNA cytosine methylation and small noncoding RNA (ncRNA) expression, specifically the microRNA (miRNA) and small nucleolar RNA (snoRNA) subtypes.

We found long lasting alterations in DNA methylation as a result of fetal alcohol exposure, specifically in the imprinted regions of the genome harboring ncRNAs and sequences interacting with regulatory proteins. A large number of major nodes from the identified networks, such as Pten signaling, contained CTCF binding sites in their promoters, illustrating the functional consequences of alcohol induced changes to DNA methylation.

Next, we assessed ncRNA expression using two independent array platforms and qPCR. The results identified 34 genes that are targeted by the deregulated miRNAs. Of these, four (Pten, Nmnat1, Slitrk2, and Otx2) were viewed critical in the context of FASD given their roles in the brain.

Furthermore, ~20% of the altered ncRNAs mapped to three imprinted regions: Snrpn-Ube3a, Dlk1-Dio3, and Sfmbt2, which showed differential methylation and have been previously implicated in neurodevelopmental disorders.

The findings of this report help to expand on the mechanisms behind the long lasting changes in the brain transcriptome of FASD individuals. The observed changes may contribute to the initiation and maintenance of the long lasting effect of alcohol.

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Medicaid care management: Description of high-cost addictions treatment clients

High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control.

We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals < 90th percentile of AODTx expenditures (n = 41,054); high-cost clients in the top decile of AODTx expenditures (HC; n = 5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data.

HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals.

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Request Reprint E-Mail: cneighbors@casacolumbia.org

Sunday, April 14, 2013

FASD News - 14/2013

NEWS and ARTICLES

CBC Toronto (Canada) - Alcohol And Pregnancy

Matt Galloway spoke about an ad campaign on downtown streets, with Gal Koren. He is the president of FASworld Toronto . The ad campaign is spreading awareness of Fetal Alcohol Spectrum Disorder.

Standard Digital (Kenya) - Pregnancy and alcohol don’t mix

Have you ever seen a pregnant woman drinking a certain brand of alcohol. Not in the hidden but openly? I have. And the person who was proudly refilling her glass was her husband.

Nanaimo Daily News (Canada) - Signs warn of risk in mixing booze, pregnancy

Nanaimo's liquor-service sector will soon be required to warn patrons about the dangers of mixing alcohol with pregnancy. Nanaimo city council is set to approve a new bylaw mandating liquor-licensed establishments to post warning signs about drinking while pregnant. Restaurants, pubs and liquor stores will have until January to put up the new signage or owners could the risk of facing a $100 fine.

Brandon Sun (USA) - Campaign targets drinking, pregnancy

THE North Point Douglas Women's Centre is trying to get the message out to expectant mothers about the dangers of FASD, one poster at a time.

Adelaide Now (Australia) - Foetal alcohol syndrome linked to binge drinking by mums

YOUNG women who binge drink while pregnant are producing a new wave of school children with learning difficulties, experts say.

Deccan Chronicle (India) - Booze turns A womb killer

Here is a case which should make parents who consume alcohol unmindful of the effects it would have on their yet to be born progeny sit up and take note. Fetal Alcohol Syndrome is not something to be taken casually, say docs.

West Virginia Public Broadcasting (USA) - Substance Abuse Prevention Partnership focuses on addicted babies

The Cabell County Substance Abuse Partnership hosted its seventh annual summit recently as it educates the public on the growing issues of substance abuse in pregnant moms.

CBC.ca (Canada) - Peer support reinforces breast-feeding benefits

While the percentage of women breastfeeding their babies continues to increase across the country, a Lakehead University researcher says that's not the case with Aboriginal women.

Oregon.gov (USA) - Alcohol Use by Pregnant Women

Fetal alcohol syndrome usually results from alcohol exposure at 3-8 weeks gestation. Because of this many women may be drinking while they are unaware that they are pregnant. As a result, reported alcohol use just before pregnancy may be the most accurate measure of use in early pregnancy.

UPCOMING EVENTS

First International Conference on Prevention of FASD - September 23 - 25, 2013

This is the first international conference to address the primary, secondary and tertiary prevention of FASD.

FASD: Best Practices in the Last Frontier – May 22-24 2013

The Arctic FASD Regional Training Center and the UAA Center for Behavioral Health Research and Services invites you to attend the 2013 conference on FASDs – FASD: Best Practices in the Last Frontier.

MATERIALS and VIDEOS

Human Relations Media - DRUGS, ALCOHOL & PREGNANCY

One out of ten babies in the U.S. has been exposed to drugs like cocaine and alcohol in the womb. The results are often tragic: undersized, unresponsive babies with nerve damage, seizures, deformities, impaired motor skills and (as they grow older) behavior and learning disabilities.

VancouverSunOnline - What are the Effects of Alcohol on Pregnancy?

Alcohol is a toxin and its effects on your baby if you drink to excess are well documented. Dr. Karen Buhler, family physician, discusses the effects of alcohol on pregnancy.

docstoc - Read the history of FASD - Alcohol and Pregnancy and Fetal

Gov.ma – Girls, Women and Alcohol: Making informed Choices

This resource was written by women for women to give you useful information about alcohol and help you make healthy and well-informed choices about your alcohol use. It is not designed to make women stop drinking alcohol.

New website – KnowFASD

SAMSHA - Addressing Fetal Alcohol Spectrum Disorders (FASD) In Women’s Residential Substance Abuse Treatment

SAMSHA - Integrating Sustainable Fetal Alcohol Spectrum Disorders (FASD) Services in Your Existing Service Setting

RESEARCH

PLOS - Cost of Fetal Alcohol Spectrum Disorder Diagnosis in Canada

As a result of using the most conservative approach, the cost of FASD diagnostic services presented in the current study is most likely underestimated. The reasons for this likelihood and the limitations of the study are discussed.

PubMed - Alcohol use in pregnancy: insights in screening and intervention for the clinician

Alcohol consumption during pregnancy remains a common occurrence and is associated with a multitude of adverse birth and long-term outcomes. Binge drinking in particular is shown to be particularly harmful to the developing fetus. Effects include full fetal alcohol syndrome, with characteristic facial dysmorphology, growth restriction, and developmental to delays.

Alcoholism - Diffusion Tensor Imaging Correlates of Saccadic Reaction Time in Children with Fetal Alcohol Spectrum Disorder

Eye movement tasks provide a simple method for inferring structural or functional brain deficits in neurodevelopmental disorders. Oculomotor control is impaired in children with fetal alcohol spectrum disorder (FASD), yet the neuroanatomical substrates underlying this are not known.

Alcoholism - Comments and Reflections on Ethics in Screening for Biomarkers of Prenatal Alcohol Exposure

Early identification of and intervention for fetal alcohol spectrum disorder (FASD) has been shown to optimize outcomes for affected individuals. Detecting biomarkers of prenatal alcohol exposure (PAE) in neonates may assist in the identification of children at risk of FASD enabling targeted early interventions.

PNAS - Understanding variability in ethanol teratogenicity

Ethanol is the most widely used psychoactive drug and, when used inappropriately, can have deleterious effects. The developing fetus is particularly sensitive to the deleterious effects of ethanol.

IN OTHER LANGUAGES

Tribuna (Romania) - Consecinţele consumului de droguri asupra fătului şi nou–născutului

Abuzul de droguri reprezintă o problemă de sănătate publică şi nu una legală şi este, în conformitate cu afirmaţiile American Committee of Obstetrics and Gynaecology (ACOG, 1984) unul din riscurile majore ale obstetricii contemporane atât pentru mamă cât şi pentru făt.