ALCOHOL REPORTS: 7/28/13

Saturday, August 3, 2013

Determination of Genotype Combinations That Can Predict the Outcome of the Treatment of Alcohol Dependence Using the 5-HT3 Antagonist Ondansetron

The authors previously reported that the 5′-HTTLPR-LL and rs1042173-TT (SLC6A4-LL/TT) genotypes in the serotonin transporter gene predicted a significant reduction in the severity of alcohol consumption among alcoholics receiving the 5-HT₃ antagonist ondansetron. In this study, they explored additional markers of ondansetron treatment response in alcoholics by examining polymorphisms in the HTR3A and HTR3B genes, which regulate directly the function and binding of 5-HT₃ receptors to ondansetron.

The authors genotyped one rare and 18 common single-nucleotide polymorphisms in HTR3A and HTR3B in the same sample that they genotyped for SLC6A4-LL/TT in the previous randomized, double-blind, 11-week clinical trial. Participants were 283 European Americans who received oral ondansetron (4 µg/kg of body weight twice daily) or placebo along with weekly cognitive-behavioral therapy. Associations of individual and combined genotypes with treatment response on drinking outcomes were analyzed.

Individuals carrying one or more of genotypes rs1150226-AG and rs1176713-GG in HTR3A and rs17614942-AC in HTR3B showed a significant overall mean difference between ondansetron and placebo in drinks per drinking day (−2.50; effect size=0.867), percentage of heavy drinking days (−20.58%; effect size=0.780), and percentage of days abstinent (18.18%; effect size=0.683). Combining these HTR3A/HTR3B and SLC6A4-LL/TT genotypes increased the target cohort from approaching 20% (identified in the previous study) to 34%.

The authors present initial evidence suggesting that a combined five-marker genotype panel can be used to predict the outcome of treatment of alcohol dependence with ondansetron. Additional, larger pharmacogenetic studies would help to validate these results.

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Request Reprint E-Mail: bj4x@virginia.edu

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 DA release in humans.
Employing positron emission tomography (PET), we hypothesized that beer’s flavor alone can reduce the binding potential (BP) of [¹¹C]raclopride (RAC; 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]RAC 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]RAC BP, indicating that the alcohol-associated flavor cues induced DA release. BP reductions were strongest in subjects with first-degree alcoholic relatives.
These results demonstrate that alcohol-conditioned flavor cues can provoke ventral striatal DA 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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Proteomic Approaches and Identification of Novel Therapeutic Targets For Alcoholism

Recent studies have shown that gene regulation is far more complex than previously believed and does not completely explain changes at the protein level. Therefore, the direct study of the proteome, considerably different in both complexity and dynamicity to the genome/transcriptome, has provided unique insights to an increasing number of researchers.

During the past decade, extraordinary advances in proteomic techniques have changed the way we can analyze the composition, regulation and function of protein complexes and pathways underlying altered neurobiological conditions. When combined with complementary approaches, these advances provide the contextual information for decoding large datasets into meaningful biological adaptive processes.

Neuroproteomics offers potential breakthroughs in the field of alcohol research by leading to a deeper understanding of how alcohol globally affects protein structure, function, interactions, and networks. The wealth of information gained from these advances can help pinpoint relevant biomarkers for early diagnosis and improved prognosis of alcoholism and identify future pharmacological targets for the treatment of this addiction.

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Request Reprint E-Mail: gorini@mail.utexas.edu

Friday, August 2, 2013

The Patterns of Drug and Alcohol Use and Associated Problems Over 30 Years in 397 Men

Alcohol and drug use disorders (AUDs and SUDs) and their combination are relatively common and often occur together. However, the relationships of potential early life correlates of alcohol and drug disorders to the combined diagnoses have rarely been evaluated in long-term prospective studies or in populations at high risk of one of these diagnoses but not the other.

Data were analyzed from 397 males (half with an alcohol-dependent father) who had no AUDs or SUDs at age 20 and who were followed approximately every 5 years for 3 decades. Early life correlates and the course of AUDs, SUDs, and combined disorders were evaluated for 4 groups of subjects based on subsequent alcohol and/or drug diagnoses.

While the overall rates of the development of AUDs and SUDs were 41 and 21%, respectively, the rates of the second substance-related diagnosis were almost 2-fold higher for individuals who had the first condition. Among potential risk factors, scores for externalizing traits were elevated for men with AUDs, SUDs, and their combination, but a low level of response (low LR) to alcohol was associated only with the risk of AUDs, even when observed in the context of SUDs. The same earlier life characteristics that related to AUDs and to SUDs also related to the combination of these diagnoses in the same person. Finally, in this prospective study, subjects with both AUDs and SUDs had a more severe course than subjects with either condition alone.

This prospective evaluation of a group at high risk of AUDs confirmed the selective impact of the low LR on the risk of AUDs, the relationship of externalizing characteristics to both AUDs and SUDs and confirmed the more severe clinical course for both conditions when seen together.

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Request Reprint E-Mail: mschuckit@ucsd.edu

Effects of Family History of Alcohol Dependence on the Subjective Response to Alcohol Using the Intravenous Alcohol Clamp

Alcohol use disorders are well recognized to be common, debilitating, and the risk of developing them is influenced by family history (FH). The subjective response to alcohol may be determined familialy and related to the risk of developing alcoholism. The aim of this study was to evaluate differences between family history positive (FHP) and family history negative (FHN) individuals in their response to alcohol within the domains of subjective, coordination, and cognitive effects using an intravenous (IV) clamping method of alcohol administration.

Two groups of healthy subjects, those with an FHP (n = 65) versus those who were FHN (n = 115), between the ages of 21 to 30, participated in 3 test days. Subjects were scheduled to receive placebo, low-dose ethanol (EtOH) (target breath alcohol clamping [BrAC] = 40 mg%), and high-dose EtOH (target BrAC = 100 mg%) on 3 separate test days at least 3 days apart in a randomized order under double-blind conditions. Outcome measures included subjective effects, measures of coordination, and cognitive function.

Both low- and high-dose alcohol led to dose-related stimulant and sedative subjective effects as measured the Biphasic Alcohol Effects Scale and subjective measures of “high” and “drowsy” measured on a visual analog scale. However, there were no effects of FH. Similar dose-related effects were observed on cognitive and coordination-related outcomes, but were not moderated FH.

Results from this study showed that healthy individuals responded to an IV alcohol challenge in a dose-related manner; however, there were no significant differences on subjective response, or on EtOH-induced impairment of coordination or cognition, between individuals with a positive FH for alcoholism and those with a negative FH. Results suggest that FH may not be a specific enough marker of risk, particularly in individuals who are beyond the age where alcohol use disorders often develop.

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Request Reprint E-Mail: ismene.petrakis@yale.edu

Dimensions of Parental Alcohol Use/Problems and Offspring Temperament, Externalizing Behaviors, and Alcohol Use/Problems

Alcohol consumption (AC) and alcohol problems (AP) are complex traits. How many factors reflecting parental AC and AP are present in the large prospectively followed Avon Longitudinal Study of Parents and Children cohort? Would these factors be uniquely associated with various temperamental and alcohol-related outcomes in the children?

We factor-analyzed multiple items reflecting maternal and paternal AC and AP measured over a 12-year period from before the birth of the child (n = 14,093 families). We examined, by linear regression controlling for socioeconomic status, the relationship between scales derived from these factors and offspring early childhood temperament, externalizing traits, and adolescent AC and AP (ns ranging from 9,732 to 3,454).

We identified 5 coherent factors: typical maternal AC, maternal AC during pregnancy, maternal AP, paternal AC, and paternal AP. In univariate analyses, maternal and paternal AC and AP were modestly and significantly associated with low shyness, sociability, hyperactivity, and conduct problems in childhood and early adolescence; delinquent behavior at age 15; and AC and AP at ages 15 and 18. AC and AP at age 18 were more strongly predicted by parental factors than at age 15. Maternal AC during pregnancy uniquely predicted externalizing traits at ages 4, 13, and 15.

Parental AC and AP are complex multidimensional traits that differ in their association with a range of relevant measures in their children. Controlling for background AC and AP, self-reported levels of maternal AC during pregnancy uniquely predicted externalizing behaviors in childhood and adolescence.

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Request Reprint E-Mail: kendler@vcu.edu

Risky Drinking, Risky Sex: A National Study of New Zealand University Students

Sexual risk taking and heavy alcohol use coexist in many populations of young people. A better understanding of the role of alcohol in sexual behaviors with health risks will inform preventive strategies. This study aimed to estimate the associations of risky sexual behavior with usual drinking pattern, with beliefs that alcohol will positively affect sexual experiences, and with drinking at the time of the sexual event.

We conducted a cross-sectional web-based survey of randomly selected university students on 8 New Zealand campuses in April 2009. Event-level data (drinking, partner type, and condom use at last sexual intercourse) were collected along with contextual data (usual alcohol consumption [AUDIT-C score], history of binge drinking, alcohol-related sexual enhancement expectancies). Regression models were used to estimate associations and potential mediation.

The response rate was 50.6% (n = 2,921). After survey weighting, of those respondents who had ever had sex, 32% reported they had been drinking and 56% reported using a condom at last sex; 10.7% reported that their last sexual intercourse was with a nonregular partner and without a condom (“risky sex”) (12.3% of men; 9.8% of women; p = 0.159). For both men and women, alcohol–sex expectancy scores and current drinking (AUDIT-C) scores were independently associated with amount of alcohol at last sex. For both men and women, the association of current drinking or expectancy with risky sex was mediated by alcohol at last sex.

Of the complex factors that contribute to risky sexual behavior and negative sexual health outcomes, heavy drinking appears to be important and is potentially modifiable. Addressing environmental determinants of hazardous drinking is likely to reduce negative sexual health outcomes among university students and other young people. Continuing promotion of condom use is also necessary, and further integration of health promotion activities in alcohol and sexual health is warranted.

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Request Reprint E-Mail: jennie.connor@otago.ac.nz

Activation of AMPK/TSC2/PLD by Alcohol Regulates mTORC1 and mTORC2 Assembly in C2C12 Myocytes

Ethanol (EtOH) decreases muscle protein synthesis, and this is associated with reduced mammalian target of rapamycin complex (mTORC)1 and increased mTORC2 activities. In contrast, phospholipase D (PLD) and its metabolite phosphatidic acid (PA) positively regulate mTORC1 signaling, whereas their role in mTORC2 function is less well defined. Herein, we examine the role that PLD and PA play in EtOH-mediated mTOR signaling.

C2C12 myoblasts were incubated with EtOH for 18 to 24 hours. For PA experiments, cells were pretreated with the drug for 25 minutes followed by 50-minute incubation with PA in the presence or absence of EtOH. The phosphorylation state of various proteins was assessed by immunoblotting. Protein–protein interactions were determined by immunoprecipitation and immunoblotting. PLD activity was measured using the Amplex Red PLD assay kit. PA concentrations were determined with a total PA assay kit.

PA levels and PLD activity increased in C2C12 myocytes exposed to EtOH (100 mM). Increased PLD activity was blocked by inhibitors of AMP-activated protein kinase (AMPK) (compound C) and phosphoinositide 3-kinase (PI3K) (wortmannin). Likewise, suppression of PLD activity with CAY10594 prevented EtOH-induced Akt (S473) phosphorylation. PLD inhibition also enhanced the binding of Rictor to mSin1 and the negative regulatory proteins Deptor and 14-3-3. Addition of PA to myocytes decreased Akt phosphorylation, but changes in mTORC2 activity were not associated with altered binding of complex members and 14-3-3. PA increased S6K1 phosphorylation, with the associated increase in mTORC1 activity being regulated by reduced phosphorylation of AMPKα (T172) and its target tuberous sclerosis protein complex (TSC)2 (S1387). This resulted in increased Rheb and RagA/RagC GTPase interactions with mTOR, as well as suppression of mTORC2.

EtOH-induced increases in PLD activity and PA may partially counterbalance the adverse effects of this agent. EtOH and PA regulate mTORC1 via a PI3K/AMPK/TSC2/PLD signaling cascade. PA stimulates mTORC1 function and suppresses activation of mTORC2 as part of an mTORC1/2 feedback loop.

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Request Reprint E-Mail: lqh10@psu.edu

Lifetime and Current Mood and Anxiety Disorders in Short-Term and Long-Term Abstinent Alcoholics

A high prevalence of comorbid mood and anxiety disorders has been demonstrated in alcoholics. We examined lifetime and current mood and anxiety diagnoses and symptoms in long-term (mean 7.6 years; n = 110) and short-term (mean 10.1 weeks; n = 101) abstinent alcoholics (LTAA and STAA) and nonsubstance abusing controls (NSAC; n = 82). All alcoholics met DSM-IV lifetime alcohol dependence criteria. About half of each alcoholic group had lifetime drug dependence.

Alcohol use was assessed using timeline follow-back methodology, and drug and alcohol use disorders were diagnosed using the AUDADIS-IV. Lifetime and current mood and anxiety disorder diagnoses and symptom counts were gathered using the computerized Diagnostic Interview Schedule.

Over 60% of STAA and LTAA had a lifetime internalizing diagnosis versus about 15% of NSAC, with no difference between STAA and LTAA. The group effect on lifetime diagnoses was independent of comorbid drug dependence or gender and was of comparable size for mood and anxiety disorders. Current diagnoses showed a similar pattern, except that STAA had more current mood diagnoses than LTAA. Excluding individuals with lifetime internalizing diagnoses, alcoholics still had more mood and anxiety symptoms than controls.

(i) The presence of a lifetime mood or anxiety diagnosis or of a current anxiety diagnosis did not differ between STAA and LTAA, suggesting that such diagnoses do not impact one's ability to achieve or maintain abstinence. (ii) Prevalence of mood and anxiety diagnoses was unaffected by presence of a comorbid substance use disorder, and (iii) excluding individuals with a mood or anxiety diagnosis does not eliminate mood and anxiety symptom count differences between groups.

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Request Reprint E-Mail: george@nbresearch.com

Alcohol-Metabolizing Genes and Alcohol Phenotypes in an Israeli Household Sample

Alcohol dehydrogenase 1B and 1C (ADH1B and ADH1C) variants have been robustly associated with alcohol phenotypes in East Asian populations, but less so in non-Asian populations where prevalence of the most protective ADH1B allele is low. Further, the joint effects of ADH1B and ADH1C on alcohol phenotypes have been unclear. Therefore, we tested the independent and joint effects of ADH1B and ADH1C on alcohol phenotypes in an Israeli sample, with higher prevalence of the most protective ADH1B allele than other non-Asian populations.

A structured interview assessed lifetime drinking and alcohol use disorders (AUDs) in adult Israeli household residents. Four single nucleotide polymorphisms (SNPs) were genotyped: ADH1B (rs1229984, rs1229982, and rs1159918) and ADH1C (rs698). Regression analysis examined the association between alcohol phenotypes and each SNP (absence vs. presence of the protective allele) as well as rs698/rs1229984 diplotypes (also indicating absence or presence of protective alleles) in lifetime drinkers (n = 1,129).

Lack of the ADH1B rs1229984 protective allele was significantly associated with consumption- and AUD-related phenotypes (OR = 1.77 for AUD; OR = 1.83 for risk drinking), while lack of the ADH1C rs698 protective allele was significantly associated with AUD-related phenotypes (OR = 2.32 for AUD). Diplotype analysis indicated that jointly ADH1B and ADH1C significantly influenced AUD-related phenotypes. For example, among those without protective alleles for ADH1B or ADH1C, OR for AUD was 1.87 as compared to those without the protective allele for ADH1B only and was 3.16 as compared to those with protective alleles for both ADH1B and ADH1C.

This study adds support for the relationship of ADH1B and ADH1C and alcohol phenotypes in non-Asians. Further, these findings help clarify the mixed results from previous studies by showing that ADH1B and ADH1C jointly effect AUDs, but not consumption. Studies of the association between alcohol phenotypes and either ADH1B or ADH1C alone may employ an oversimplified model, masking relevant information.

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Request Reprint E-Mail: dsh2@columbia.edu

Early Fetal Binge Alcohol Exposure Predicts High Behavioral Symptom Scores in 5.5-Year-Old Children

Fetal binge alcohol exposure has been associated with neurobehavioral and cognitive symptoms. This study explored whether binge drinking mainly before recognition of pregnancy predicted high symptom scores on the Strengths and Difficulties Questionnaire (SDQ) in 5.5-year-old children.

In a population-based, longitudinal study representative of pregnant women in Oslo, Norway, questionnaires were answered at 17 and 30 weeks of pregnancy, 6 months after term, and at child age 5.5 years (n = 1,116, constituting 66% of the original cohort). Logistic regression analyses identified factors predicting high SDQ scores, and multiple regression analyses identified direct effects on the SDQ Total.

Binge exposure (≥5 standard units per occasion [SUpo]) during pregnancy week 0 to 6, that is, 0 to 4 weeks after conception, predicted scores in the Abnormal and Borderline range on the SDQ in 5.5-year-olds, after adjusting for other confounding variables. Very early binge exposure less often than once a week predicted high symptom scores on the SDQ Total (p = 0.05) and Hyperactivity/Inattention (significant), while exposure at least once a week demonstrated a 3- to 5-fold significant increase in high symptom scores on Total, Emotional, and Conduct problems. Reporting ≥8 SUpo had stronger predictive power than reporting 5 to 7 SUpo. The results were not explained by participants reporting major lifetime depression. Other predictive factors, although weaker, were maternal symptoms of depression and anxiety during the child's infancy. High education (mother and father), high income (maternal partner), higher child birth weight, and child female sex reduced the likelihood of high SDQ symptom scores. Path analysis demonstrated early binge exposure to have a direct effect on the SDQ Total score.

Binge drinking up to 4 weeks after conception had a strong and direct predictive effect on SDQ symptom scores in 5.5-year-olds. These results strongly support the advice to avoid binge drinking when planning pregnancy

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Thursday, August 1, 2013

The Role of Sociodemographic Factors in the Risk of Transition from Alcohol Use to Disorders and Remission in Singapore

The aim of the study was to define predictors of transition from alcohol use to disorders, and their remission, among adults residing in Singapore.
The Singapore Mental Health Study was a cross-sectional survey conducted from December 2009 to December 2010. Information on alcohol use, regular use, DSM-IV criteria for abuse and dependence, and remission among 6616 respondents was obtained with the Composite International Diagnostic Interview.

The prevalence of lifetime alcohol use (drinking at least once in the lifetime) and regular use (ever drinking at least 12 drinks in a 12-month period) was 66.6 and 32%, respectively. Of the regular drinkers, 10.1% progressed into alcohol abuse; 6.9% of abusers turned to alcohol dependence and 16.6 and 7.1% of those with history of alcohol abuse and/or dependence subsequently reported remission defined as cessation of alcohol use and the absence of any symptoms for at least 2 years before interview. Transitions to regular use and to dependence were associated with younger age, Indian ethnicity and an early age of onset of drinking, and women had a higher risk than men of transition from abuse to dependence. Remissions were associated with older age, Malay ethnicity and late age of onset.

The rates of alcohol use and transition to disorders were lower than in other developing countries that have been studied. Sociodemographic predictors include younger age of onset of drinking, something that intervention programs and preventive strategies in Singapore should note.

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Request Reprint E-Mail: edimansyah_abdin@imh.com.sg

Proteomic Approaches for Studying Alcoholism and Alcohol-Induced Organ Damage

Proteomics research is concerned with the analysis of all proteins found in an organism, tissue, cell type, or cellular structure. The shotgun proteomic approach, which involves two-dimensional gel electrophoresis or liquid chromatography combined with mass spectrometry (MS), is used to identify novel proteins affected by alcohol. More targeted analyses study protein–protein interactions using such techniques as the yeast two-hybrid system, affinity chromatography, or immunoprecipitation. Finally, proteomic strategies can be combined with genomic research findings using computer analyses (i.e., in silico).

All of these approaches have been used in the alcohol field. These studies have identified proteins in various brain regions whose expression is affected by alcohol. Other investigators have used proteomic approaches to identify proteins that could serve as potential biomarkers of alcohol use.

Finally, interaction proteomic analyses have begun to identify proteins involved in several nerve signaling networks in the brain, which then can serve as targets for further studies on alcohol’s effects. Future proteomic studies likely will shed more light on the mechanisms underlying alcohol’s actions on the body.

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Making the Case: Tools for Supporting Local Alcohol Policy in Ontario

Alcohol-related harms are often experienced at a local level, directly affecting communities, roadways and neighbourhoods. Local alcohol policies can be an important and effective way to promote moderate alcohol consumption, support community values, raise awareness of harms, influence community social norms and promote healthier communities (Government of British Columbia, 2012). Babor et al. (2010) describe alcohol policy as purposeful efforts or decisions to minimize and/or prevent alcohol-related harms. Policies can include implementing specific strategies, supporting priorities or allocating resources based on need (Babor et al., 2010). Further, local alcohol policy is most effective when it is aligned with provincial and national alcohol strategies and guided by provincial legislation.

The purpose of this resource is to
› foster awareness about, and underscore the need for local action on alcohol-related harms, and
› support the development and implementation of local alcohol policies within communities across Ontario.
This resource is produced by the Centre for Addiction and Mental Health (CAMH) Health Promotion Resource Centre and Public Health Ontario (PHO). It is designed for Healthy Communities Partnerships and other public health stakeholders in Ontario, particularly those new to the field of alcohol policy.

This resource includes three tools. The tools are supported by information on the Ontario context including key facts about the burden of alcohol and the current public health landscape. The tools include:

1. Alcohol Policy Approaches Table. This tool includes dozens of local policy action examples mapped to the seven internationally recommended policy approaches (Babor et al., 2010) and strategies that can be used to address them (Giesbrecht et al., 2011). These are displayed in a user-friendly table found on pages 10-11.
2. Local Action Tables. The second tool is displayed in seven tables, one for each of the internationally recommended policy approaches. This tool maps each of the local policy actions from the first tool against the areas of action recommended by the National Alcohol Strategy (National Alcohol Strategy Working Group, 2007), the Ontario Public Health Standards(2008), and who might lead the effort to implement the local action. These tables are on pages 13-20.
3. Resource Inventory. This annotated collection of journal articles, reports, toolkits and guides shows places to get further information about taking policy action to reduce alcohol-related harms. The inventory can be found on pages 21-37.

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Global Actions: Commitments to Reduce Harmful Drinking - Aug 1 2013

Global Actions in Focus

Progress in Colombia initiatives

On July 29, 2013, Global Actions hosted a meeting in Bogotá, Colombia with Commitments signatory companies Bavaria/SABMiller, Pernod Ricard, and Diageo to assess and evaluate Colombia’s ongoing projects, challenges and future plans. Participants also discussed transitioning the programs to local sustainability.

Representatives from ICAP, SABMiller, Pernod Ricard, and Diageo meet to discuss the Global Actions Drink Driving Initiative in Colombia

Progress continues in cities including Chia, Yumbo, and Quibdó. In May 2013 the Global Actions Drink Drive Initiative hosted a workshop for law enforcement and transit authority officials in Chia. Also in May, 163 individuals participated in drink driving seminars in Yumbo, and reviewed Colombian drink driving laws and sobriety checkpoint best practices.

On July 30, 2013, Global Actions signed a cooperation agreement with the city of Quibdó to work on Phase Two of the Patrullero Project. Future activities in Quibdó include a baseline alcohol and substance abuse study among students, and increasing the effectiveness and frequency of sobriety checkpoints in collaboration with the Secretary of Mobility and Transit Police. Diageo will also present the DRINK iQ program to university students in Quibdó.

Channel Research, the independent evaluators for the Global Actions Drink Driving Initiatives, will conduct a third site visit to Colombia the week of August 12, 2013. The evaluators will be accompanied by International Center for Alcohol Policies (ICAP) Program Manager Shushanna Mignott and will be speaking with signatory representatives and stakeholders to discuss progress on the drink driving initiatives. Previous site visits were conducted in China and Mexico in April and May of this year, respectively.

Key Recent Milestones

· Vietnam: Global Actions and the National Traffic Safety Committee (NTSC) held a public awareness campaign workshop in Vinh City, Vietnam, on July 29 and 30, 2013.

What's Happening Next

· Mexico: During the week of August 5, 2013, ICAP will partner with the Secretary General of Government (SGG), the Secretary of the Public Education (SEP) of Puebla, and the System for Integral Family Development (DIF) of Puebla to pilot drink driving training for the freshmen of Colegio Nacional de Educación Profesional Técnica (CONALEP).

PAHO launches on-line courses to train health personnel in the detection and management of people with problems related to the use of alcohol and other drugs,

Today, the Pan American Health Organization/World Health Organization (PAHO/WHO) launched free online courses to train health personnel in the detection and management of people with problems related to the use of alcohol and other drugs, as well as public policies to reduce the demand for both alcohol and drugs.

These courses are available online for physicians and nurses, social workers, professionals who work with young people or in detention centers, among others, for the purpose of strengthening health sector response and introducing effective interventions into routine primary care. The training ranges from how to detect symptoms of alcohol or drug abuse to how to conduct a brief intervention and refer individuals to more extensive treatment. The public policy trainings cover the effectiveness of regulations on control of supply and demand, harm reduction, treatment, and health education.

These courses—four in Spanish and two in English—are available on the website of the Virtual Campus for Public Health— http://www.campusvirtualsp.org/?q=en. They are free of charge and are available on demand for individual study. In each course, most of the modules have an audio explanation, written course content, and reference materials, and some also have videos to demonstrate examples. Students take self-evaluations to advance from one module to the next. > > > > Read More