SMART RECOVERY®
MEETING FACILITATOR TRAINING PROGRAM


September 2007

SMART Recovery® now offers a distance training program for individuals interested in starting or facilitating an existing SMART Recovery F2F or online meeting within 3 months of training program completion.

The Meeting Facilitator Training Program is comprised of a combination self-study and Evoice voice on-line discussions, is available for those desiring to start a local SMART Recovery Meeting, and those desiring to volunteer within the SMART Recovery Online Community.
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Examining the effect of perceived availability on craving for alcohol: A quasi-experimental approach

Addiction Research & Theory, Volume 15, Issue 3 January 2007 , pages 231 - 245

The impact of contextual cues in motivating alcohol and other drug use may be influenced by the perceived availability of the substance.

This study examined the relationship between perceived availability and alcohol cue reactivity using a quasi-experimental design that harnessed the legal age of alcohol availability in the United States.

The results indicated significant main effects of cue type, with alcohol cues eliciting significantly larger increases in subjective urge to drink and positive affect, as well as increased consumption of placebo alcohol. Moreover, a significant main effect of availability information was detected, with unavailability information generating a greater urge to drink.

Potential mechanisms underlying this effect and future directions are discussed.

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Reprint Request E-Mail: james_mackillop@brown.edu
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Time to change - an exploratory study of motivation among untreated and treated substance abusers

Addiction Research & Theory, Volume 15, Issue 3 January 2007 , pages 247 - 261

This exploratory study examines whether the attitudes towards change and treatment of untreated non-abstinent substance abusers differ from those of patients undergoing treatment in residential care. The attitudes of the three groups - untreated, voluntarily and compulsorily treated subjects - differed with respect to lifestyle change. Factor analysis of the measures revealed one component of primary interest, general willingness to change. Results show that willingness to change was correlated with other attitudinal characteristics in the three groups. The stability of substance abusers' motivation is discussed with the focus on different social contexts' influence on change-compliant attitudes and behaviour. Read Full Abstract

Reprint Request E-Mail: mats.ekendahl@socarb.su.se
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Voices of sobriety: Exploring the process of recovery through patient testimonials
Addiction Research & Theory, Volume 15, Issue 2 2007 , pages 127 - 140







A qualitative content analysis was conducted in a Hungarian therapeutic community for substance abusers to explore processes of recovery and identify possible threats of relapse.

There are marked differences between the groups both in the emerging themes and in the sequential development of certain themes. Texts of recovering addicts are characterised by reflections on personal transformation experienced as a rite of passage and experiential knowledge on the care of self and spirituality while those who relapse often raise "profane" content and copy their fellows' speeches. Possible impact of these differences on recovery and relapse are discussed.

Results suggest that spirituality may have a major role in recovery.

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Reprint Request E-Mail: Kelemen@btk.pte.hu
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News Release - Bariatric surgery can make more people sensitive to alcohol, Stanford surgeon finds


June 14 , 2007
STANFORD, Calif. — An Oprah Winfrey-inspired study done by researchers at the Stanford University School of Medicine has found that patients who undergo gastric bypass surgery to lose weight will get drunk faster and take longer to get sober.

“It may sound strange, but Oprah really did inspire this study,” said John Morton, MD, MPH, assistant professor of surgery and senior author of the study, who presented the information June 14 at the annual meeting of the American Society for Bariatric Surgery. Referring to an episode of The Oprah Winfrey Show, Morton said, “After the Oprah show ‘Suddenly Skinny’ aired in October 2006, I got question after question from patients asking, ‘What happens when I drink alcohol?’”
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Adolescents & Alcohol: Problems related to Drinking

Institute of Alcohol Studies
17 April 2007


This factsheets contains specific information on problems related to adolescents drinking alcohol.



The peak age for drunkenness convictions and cautions is 18 for both men and women. In 1995, under 18s accounted for 7% of all drunkenness convictions/cautions, and 18-21 year olds for 16% of the total. However, rates of convictions are difficult to interpret as they reflect police practices as much or more than the actual incidence of drunkenness. It is certain there is much more drunkenness among young people than the figures for convictions make it appear.

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Adolescents and Alcohol

Institute of Alcohol Studies
5 April 2007




In the interwar period in the UK young people aged 18-24 were the lightest drinkers in the adult population and the group most likely to abstain. Nor did alcohol play a significant part in the youth culture that came into existence in the 1950s, this being more likely to involve the coffee bar than the pub. It was not until the 1960s that pubs and drinking became an integral part of the youth scene. By the 1980s, those aged 18-24 years had become the heaviest drinkers in the population, and the group least likely to abstain.

By the year 2002, hazardous drinking i.e. drinking bringing the risk of physical or psychological harm now or in the future, was most prevalent inteenagers and young adults.

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INSURANCE: SOLVING SOME ALCOHOL PROBLEMS AND CAUSING OTHERS

By Jonathan Goodliffe, solicitor

Problem drinking may lead to financial problems for the drinker and those affected by his behaviour. In England 21% of adults have an alcohol use disorder likely to cause problems for them. 3.6% of adults are alcohol dependent (i.e. in common language they might be labelled "alcoholics")

Alcohol is a proven factor often causing or contributing to the occurrence of many risks against which insurance is commonly taken out. These include, for instance, death and ill health, crime, accidents (including motor accidents) and fire. There are other risks in relation to which a link with problem drinking has been suggested but has yet to be scientifically established. These include professional negligence and marine collisions.

Insurance can sometimes pay for treatment for the effect of alcohol misuse. It can help to meet the cost of alcohol related harm. Sometimes the insured may be encouraged to avoid alcohol problems, by risk management procedures required by the insurer or by the prospect of paying higher premiums if those procedures are not adopted.

Often alcohol related risks may be excluded from the scope of the cover. Sometimes the non-payment of an insurance claim is an alcohol problem in its own right. Nondisclosure of (among other things) problem drinking by the person applying for cover ("the proposer") may invalidate the insurance. Insurance can also be problematic when it contributes to dangerous behaviour by protecting people from the consequences, as when an alcoholic makes a suicide attempt believing that his family will be able to claim on his insurance.

This paper focuses on the non-disclosure issues whilst also touching other aspects of insurance's relationship with alcohol related risk. I hope to show that there are areas of common interest between the field of alcohol studies on the one hand and of insurance on the other. Focus on common ground may lead to the development of more constructive policies for the reduction of alcohol related harm, for the management of alcohol related risk and for the development of fairer sales techniques.

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Reducing the Harm Caused by Alcohol: A Coordinated European Response

Events : Conference details

With financial support from the European Commission

Tuesday 13 November 2007

Venue: Royal College of Physicians

Location: London

Description
This one day conference, organised by the Royal College of Physicians, aims to bring together representatives of the medical professions from the United Kingdom and from Europe to share the latest evidence and experience and to agree and prod

Conference Organiser: Royal College of Physicians

• Programme Available

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Development of a bibliography on religion, spirituality and addictions.
Drug Alcohol Rev 2007;26:389 - 395]








The aim of this study was to develop a comprehensive annotated public-domain bibliography of the literature on spirituality and addictions to facilitate future research and scholarship.

A search was conducted of all citations listed in the MEDLINE, PsychINFO and ALTA Religion databases covering a period from 1941 to 2004 using the following search terms: substance abuse, substance dependence, addiction, religion, spirituality.

The literature is voluminous, but has focused primarily in a few areas. Common findings included an inverse relationship between religiosity and substance use/abuse, reduced use among those practising meditation and protective effects of 12-Step group involvement during recovery.

Although sound instruments are available for measuring spirituality, studies have tended to use simplistic, often single-item measures.

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Reprint Request E-Mail: ethicdoc@comcast.net
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Prodynorphin gene promoter repeat associated with cocaine/alcohol codependence
Addiction Biology (OnlineEarly Articles). 8 June 2007

There is strong evidence for a genetic contribution to individual differences in vulnerability to drug addictions. Studies have shown that the 68-base pair repeat polymorphism in the promoter region of the human prodynorphin gene contains a putative AP-1 binding site, and that three or four repeat copies result in greater transcriptional activation.

The promoter region of the prodynorphin gene containing the repeat was amplified from genomic DNA by polymerase chain reaction and analyzed via gel electrophoresis. Statistical tests were performed with data stratified by the three major ethnic groups studied: African American, Caucasian and Hispanic.

For analyses, genotypes were grouped into short (1,1; 1,2; 2,2), short/long (1,3; 2,3; 1,4; 2,4) and long (3,3; 3,4; 4,4) repeats. Deviation from Hardy–Weinberg Equilibrium in the African American control group necessitated testing for association using grouped genotypes rather than grouped alleles. In controls, a significant difference was found in grouped genotype distribution among ethnicities.

We found a point-wise, but not experiment-wise across-ethnicities, significant difference in grouped genotype frequency between the cocaine/alcohol-codependent group and the controls in African Americans, with genotypes containing longer alleles found at higher frequency in the codependent group.

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Reprint Request E-Mail: kreek@rockefeller.edu
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Accumbens Homer2 Overexpression Facilitates Alcohol-Induced Neuroplasticity in C57BL/6J Mice

Neuropsychopharmacology advance online publication 13 June 2007;













Homer proteins are integral components of the postsynaptic density that are necessary for alcohol-induced neuroplasticity within the nucleus accumbens (NAC).

In this report, we describe the effects of chronic alcohol consumption upon NAC Homer expression and investigate the functional consequences of mimicking the alcohol-induced changes in Homer expression vis-à-vis alcohol-induced changes in NAC neurochemistry and behavior.

Chronic alcohol consumption under continuous access (3 months; daily intake 11.21.5 g/kg/day) produced a robust increase in NAC Homer2 protein levels that was apparent at 2 days, 2 weeks, and 2 months following withdrawal from alcohol drinking.

The increased Homer2 expression was accompanied by a less enduring elevation in total mGluR1 and NR2b levels that were evident at 2 days and 2 weeks but not at the 2-month time point. Mimicking the alcohol-induced increase in Homer2 levels by viral transfection of NAC neurons in alcohol-preferring C57BL/6J inbred mice enhanced behavioral output for alcohol reinforcement and increased alcohol intake under both preprandial and postprandial conditions. Moreover, NAC Homer2 overexpression facilitated the expression of an alcohol-conditioned place preference, as well as the development of motor tolerance.

Finally, NAC Homer2 overexpression facilitated NAC glutamate and dopamine release following an acute alcohol injection and augmented alcohol-induced dopamine and glutamate sensitization, but did not affect NAC -aminobutyric acid levels.

Thus, an upregulation in NAC mGluR–Homer2–N-methyl-D-aspartic acid receptor signaling appears to be an important molecular adaptation to alcohol that promotes neuroplasticity facilitating motivational drive for alcohol and the development of alcoholism-related behaviors.


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Reprint Request E-Mail: szumlinski@psych.ucsb.edu


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Stress-response-dampening effects of alcohol: Attention as a mediator and moderator.
Journal of Abnormal Psychology. 2007 May Vol 116(2) 362-377





The present study sought to characterize alcohol's stress-response-dampening (SRD) effects on multiple measures of stress and whether these effects are mediated by reductions in sustained attention and, further, whether baseline levels of sustained attention moderate SRD.

As hypothesized, differences in sustained attention partially mediated the effects of alcohol on skin conductance (but not heart rate or self-reported anxiety) and served as a moderator of alcohol's effects on skin conductance response.

Findings are discussed in terms of theoretical links among alcohol consumption, specific cognitive abilities, and stress reactivity.

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Reprint Request E-Mail: SherK@missouri.edu
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Nonnormality and divergence in posttreatment alcohol use: Reexamining the Project MATCH data "another way."

Journal of Abnormal Psychology. 2007 May Vol 116(2) 378-394

Alcohol lapses are the modal outcome following treatment for alcohol use disorders, yet many alcohol researchers have encountered limited success in the prediction and prevention of relapse. One hypothesis is that lapses are unpredictable, but another possibility is the complexity of the relapse process is not captured by traditional statistical methods.

Data from Project Matching Alcohol Treatments to Client Heterogeneity (Project MATCH), a multisite alcohol treatment study, were reanalyzed with 2 statistical methodologies: catastrophe and 2-part growth mixture modeling. Drawing on previous investigations of self-efficacy as a dynamic predictor of relapse, the current study revisits the self-efficacy matching hypothesis, which was not statistically supported in Project MATCH.

Results from both the catastrophe and growth mixture analyses demonstrated a dynamic relationship between self-efficacy and drinking outcomes. The growth mixture analyses provided evidence in support of the original matching hypothesis: Individuals with lower self-efficacy who received cognitive behavior therapy drank far less frequently than did those with low self-efficacy who received motivational therapy.

These results highlight the dynamical nature of the relapse process and the importance of the use of methodologies that accommodate this complexity when evaluating treatment outcomes.

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Reprint Request E-Mail: katiew@uic.edu

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SAMHSA FASD Center for Excellence

Update


What’s New From the SAMHSA FASD Center for Excellence
NOFAS Affiliates Summit, Hill Day and Leadership Awards Benefit: June 12-13, 2007
Second National Summit on Preconception Health and Health Care: October 29-31, 2007 _________________________________________________________________________________________________________________________

The SAMHSA FASD Center for Excellence has several new publications available on the Web site. The publications include:
Five “What You Need To Know” Fact Sheets:
The Physical Effects of Fetal Alcohol Spectrum Disorders
Adopting and Fostering Children With Fetal Alcohol Spectrum Disorders
Preventing FASD: Healthy Women, Healthy Babies
Effects of Alcohol on a Fetus
Effects of Alcohol on Women

The fact sheets can be accessed on the Grab and Go section under Fact Sheets and Brochures at http://www.fasdcenter.samhsa.gov/grabGo/factSheets.cfm

Two Family-Oriented Booklets:
My Sibling Has a Fetal Alcohol Spectrum Disorder. Can I Catch It?
What Do I Do? Helping Your Kids Understand Their Sibling’s Fetal Alcohol Spectrum Disorder

The booklets are available in print from NCADI. Ordering information can be accessed at http://www.fasdcenter.samhsa.gov/publications/booklets.cfm

Native Resource Kit:
The materials in this kit have been specially designed for the needs of Native American communities. The kit can be accessed on the Grab and Go section under

Native Resource Kit at http://www.fasdcenter.samhsa.gov/grabGo/NativeKit.cfm

Two New Courses:
FASD - The Course

This course provides an overview of risk factors for FASD, signs and symptoms, and prevention and treatment methods. It is designed primarily for health, mental health, and social service providers, educators, and other professionals who work with children, adolescents, and adults with an FASD. Parents, caregivers, and family members may also find it helpful

FASD—The Course can be accessed on the Education/Training section at
http://www.fasdcenter.samhsa.gov/educationTraining/courses/FASDTheCourse/splash.cfm

Curriculum for Addiction Professionals (CAP): Level 1 CAP 1 is intended for social workers, certified addiction counselors, psychologists, psychiatrists, and others in the treatment and recovery field. Parents, caregivers, and other family members may also find it helpful. Although the information in this curriculum pertains primarily to working with women and women with children in substance abuse treatment, some of the information also applies to adult men and adolescents in treatment programs.

You can access CAP 2 on the Education/Training section at http://www.fasdcenter.samhsa.gov/educationTraining/courses/CapCurriculum/index.cfm

2. NOFAS will host their Affiliates Summit, Hill Day, and Leadership Awards Benefit on June 12-13, 2007 in Washington, D.C. The sixteen NOFAS Affiliates will meet on Tuesday, June 12 from 9:00 a.m. until 4:00 p.m. to feature current programs and set the coalition’s priorities. The fourth annual Hill Day will be held on Wednesday, June 13 beginning with a breakfast orientation leading into a full day of FASD constituent meetings with lawmakers and Congressional staff. The fifteenth annual awards reception hosted by United States Senator Lisa Murkowski and the Honorable Tom Daschle and Linda Hall Daschle (NOFAS founding members) will begin at 6:00 p.m. on Capitol Hill.

For more information about the events and to register, contact Tom Donaldson at donaldson@nofas.org or (202) 785-4585.

3. The Second National Summit on Preconception Health and Health Care will be held October 29-31, 2007 in Oakland, California. The Summit is being hosted by the Preconception Care Council of California, March of Dimes California Chapter, and the California Department of Health Services, in collaboration with the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). Abstracts for oral or poster presentations, as well as proposals for special sessions, including case studies, are currently being accepted. The deadline for abstract and proposal submission is June 18, 2007.

For more information about the Summit, abstract and proposal submission, and to register, access the March of Dimes California Chapter’s Web site at

http://www.marchofdimes.com/california/4947_24789.asp. The deadline for early registration is September 15, and the deadline for all registration is October15, 2007.

Contributor: Peggy Seo Oba
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Alcohol-specific rules, personality and adolescents' alcohol use: a longitudinal person-environment study

Addiction 102 (7), 1064–1075.

To examine the bi-directional associations between providing alcohol-specific rules and adolescents' alcohol use. Further, to explore person–environment interactions, we tested whether Big Five personality traits moderate the assumed association between providing alcohol-specific rules and adolescents' alcohol use.

In general, results of structural equation modelling showed that providing clear alcohol-specific rules lowers the likelihood of drinking initiation, regardless of the age of the youngsters. Once adolescents have established a drinking pattern, the impact of parental alcohol-specific rules declined or even disappeared. Finally, the Big Five personality traits did not moderate the association between providing alcohol-specific rules and adolescents' alcohol involvement.

In sum, in particular during the initiation phase of drinking, parents could prevent the drinking of their offspring, regardless of the age or personality of their youngsters, by providing clear alcohol-specific rules

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Reprint Request E-Mail: h.vandervorst@bsi.ru.nl

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Enhancing the validity and utility of randomized clinical trials in addictions treatment research: I. Treatment implementation and research design
Addiction 102 (7), 1047–1056.


This paper is the first in a series that examines methods for improving the validity and utility of randomized clinical trials (RCTs) in addictions treatment research. The specific foci of this article are treatment implementation and research design.

We begin by considering the conditions under which the RCT provides an appropriate design choice. Sections that follow discuss methodological issues with respect to RCT structure and collaborative arrangements; treatment specification, delivery and cost; experimental design; and randomization/blinding procedures. We emphasize the importance of advance planning; treatment integrity and discriminability; treatment standardization; staff training and supervision; client compliance; maintenance of between-group equivalence across study conditions; and inclusion of appropriate comparison groups in study designs.

Investigators are encouraged to maximize the internal validity of RCTs, but also to consider methods for enhancing external validity. The utility of addictions RCTs for advancing theory and improving clinical practice can be enhanced by investigating underlying mechanisms of action.

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Reprint Request E-Mail: fdelboca@cas.usf.edu
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Mexicans and alcohol: patterns, problems and policies

Addiction 102 (7), 1041–1045.

Reprint request E-Mail: medinam@imp.edu.mx

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Alcohol dependence with comorbid drug dependence: genetic and phenotypic associations suggest a more severe form of the disorder with stronger genetic contribution to risk
Addiction 102 (7), 1131–1139.

Twin data suggest that alcohol dependence comorbid with illicit drug dependence represents a more heritable form of the disorder. In the Collaborative Study on the Genetics of Alcoholism sample, approximately half the alcohol-dependent individuals also meet diagnostic criteria for illicit drug dependence.

In this study, we tested for heterogeneity in the association between the muscarinic acetylcholine M2 receptor gene (CHRM2) and alcohol dependence, reported previously in the full sample, among the subgroups of alcohol-dependent individuals with and without comorbid drug dependence.

The evidence for association between CHRM2 and alcohol dependence came entirely from the subgroup of individuals with comorbid drug dependence. There was no evidence of association with CHRM2 among the alcohol-dependent individuals without drug dependence.

Subsequent phenotypic analyses suggest that the subgroup of alcohol-dependent individuals with comorbid drug dependence differ on a number of other phenotypic characteristics, including several measures of the severity of their alcohol problems, personality traits and comorbid psychiatric disorders.

These analyses provide specific genetic evidence suggesting that alcohol dependence with comorbid drug dependence represents a particularly severe form of the disorder, with higher genetic contribution to vulnerability.

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Reprint Request E-Mail: dickd@psychiatry.wustl.edu
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Health - What kind of drinker are you?



Whether we have a few glasses after work or a weekly binge, most boozers have one thing in common - we put away more than we think

By Julia Stuart
Published: 12 June 2007

The Middle-Class Wine Buff. . . .

The Alcoholic. . . .

The Teenage Drinker. . . .

The No-Head-for-Alcohol Drinker. . . .

The Social Drinker. . . . .

The Binge Drinker. . . . .

The truth about units. . . .

But isn't drinking good for you?. . . .

Read Full Article

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House Energy and Commerce Committee Hearings on June 15th!

Dear Recovery Advocate,

We need your help today to continue building momentum for meaningful Congressional action to end insurance discrimination this year!

We've just learned that the House Energy and Commerce committee will hold hearings this Friday, June 15th on the Paul Wellstone Mental Health and Addiction Equity Act of 2007, H.R. 1424!

Thanks to your advocacy, there is growing support in Washington, DC to require equity in insurance coverage for addiction treatment and recovery. The House Education and Labor committee has scheduled a hearing for July 10th, paving the way for action in this session of Congress. Faces & Voices will send you another Alert about that hearing.

In other developments, the Senate continues to deliberate on its version of the bill, which still needs to be strengthened to protect existing state laws that provide even better coverage for people with mental illnesses and addiction.

Here is a one-page fact sheet about the Paul Wellstone Mental Health and Addiction Equity Act.

WHAT YOU CAN DO:

1. Find out if your U.S. Representative is a co-sponsor of H.R. 1424

2. Call your Representative's office by calling the House switchboard at: 202-222-3121. Find out who your Representative is by entering your zip code in the upper left hand corner.

3. Ask to speak with the staff person who handles health issues.

4. Ask them to work to enact H.R. 1424, The Paul Wellstone Mental Health and Addiction Equity Act of 2007 this year. If he or she is a co-sponsor, thank them for their support.

5. Let them know about the hearing on June 15th before the House Energy and Commerce Committee. If your Representative is a member of that committee (see the list here) your call is particularly important!

Act now! Reach your Representative's office by calling the House switchboard at 202-224-3121

Email us to let us know about your call!

Thanks so much for your tireless advocacy!

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Population drinking and liver cirrhosis mortality: is there a link in eastern Europe?
Addiction (OnlineEarly Articles). 12 June 2007




To analyse the relationship between population drinking and liver cirrhosis mortality in eastern European countries and compare it with similar findings from western Europe.

Cirrhosis mortality rates were related significantly to population drinking in eight of nine eastern European countries and both relative and absolute alcohol effects laid within the range of previous western European estimates. A 1-litre increase in per capita consumption was on average estimated to cause three to four additional cirrhosis deaths per 100 000 for men and one additional death for women. The absolute effects for men were relatively high in a European perspective: stronger than in mid- and northern Europe and only marginally weaker in comparison with southern Europe.

A reduction in per capita alcohol consumption would prevent many cirrhosis deaths in eastern Europe, particularly for men. It is suggested that further studies of the extent other forms of alcohol-related mortality respond to changes in population drinking in eastern Europe would be valuable.

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Reprint Request E-Mail: mats.ramstedt@sorad.su.se

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Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: a randomized controlled clinical trial Addiction (OnlineEarly Articles). 12 June 2007


To evaluate the effectiveness of brief alcohol intervention (BAI) in reducing alcohol use among hazardous drinkers treated in the emergency department (ED) after an injury; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking.

Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment (35.6%, 34.0%, 37.0%, respectively, P = 0.71). Data also indicated similar reductions in drinking frequency, quantity, binge drinking frequency and Alcohol Use Disorders Identification Test (AUDIT) scores across groups. All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months. A model including age groups, gender, AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome.

This study provides the evidence that a 10–15-minute BAI does not decrease alcohol use and health resource utilization in hazardous drinkers treated in the ED, and demonstrates that commonly found decreases in hazardous alcohol use in control groups cannot be attributed to the baseline alcohol assessment.

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Reprint Request E-Mail: jean-bernard.daeppen@chuv.ch
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News Release - 2006 Report by Florida Medical Examiners Commission on Drugs Identified in Deceased Persons
June 11, 2007

Today, the Florida Department of Law Enforcement (FDLE) released the Florida Medical Examiners Commission Report on Drugs Identified in Deceased Persons. The report contains information compiled from autopsies performed by medical examiners across the state in 2006. During that period there were more than 171,000 deaths in Florida. Of those, 7,741 individuals were found to have died with one or more of the drugs specified in this report in their bodies.
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The report indicates the three most frequently occurring drugs found in decedents were Ethyl Alcohol (3,698), Cocaine (2,052), and all Benzodiazepines (1,987). The drugs that caused the most deaths were Cocaine, Methadone, all Benzodiazepines, Oxycodone, Alprazolam, Ethyl Alcohol, Hydrocodone, and Morphine.
. . . . . .

Read Full News Release

Read Full Report (PDF)
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Alcohol Consumption and Fatty Acid Intakes in the 2001-2002 National Health and Nutrition Examination Survey
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles). 11 June 2007


Alcohol consumption has the potential to affect dietary intakes of nutrients; however, little is known about fatty acid intakes among alcohol consumers in the U.S. population.

Energy intake showed a significant increasing trend across alcohol consumption categories in both genders and binge-drinking categories in men. Women binge drinkers also showed a higher energy intake compared with nonbinge drinkers. Among men, decreased nutrient densities of saturated, monounsaturated, polyunsaturated, linoleic, and α-linolenic acids were associated with increasing alcohol consumption. Binge-drinking men but not women had significantly decreased intakes of total saturates, monounsaturates, polyunsaturates and linoleic, α-linolenic, eicosapentaenoic, and docosahexaenoic acid.

When alcohol energy was excluded from calculation of nutrient densities, the results were similar to those with alcohol energy included, except that total saturated and monounsaturated fatty acid differences were no longer significant. In addition, there was an inverse relationship among men between binge-drinking frequency and total polyunsaturates, linoleic, α-linolenic, and eicosapentaenoic acids.

Our cross-sectional results suggest that alcohol consumption may impact the dietary intake of essential fatty acids (EFAs). Given the public health importance of both alcohol consumption and intakes of EFAs, prospective studies of the relation should be considered.

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Cerebellar Vermis Proteome of Chronic Alcoholic Individuals
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles). 11 June 2007


Cerebellar changes are commonly associated with alcoholism and chronic alcohol consumption can produce profound impairments in motor functioning and various aspects of cognition. Although the mechanisms underlying alcohol-induced changes in the cerebellar vermis are poorly understood, observations in the alcoholic vermis are thought to be consequential to common alcohol-related factors, particularly thiamine deficiency.

These results suggest that clinically and pathologically uncomplicated alcoholic cases may not in fact be "uncomplicated," as at the proteome level we seem to be isolating the confounding effects of nutritional deficiencies and liver dysfunction and perhaps their role in alcohol-related vermis damage.

Together, these results indicate that the alcohol-related pathology of the vermis is more multifactorial than other brain regions examined previously (prefrontal region and CC splenium).

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The Influence of Alcohol on Blood Pressure


C o n c l u s i o n : P u b l i c H e a l t h I m p l i c a t i o n s

This report shows a clear association between alcohol consumption and blood pressure. Systolic blood pressure (SBP) rose as weekly alcohol consumption rose, with an average increase of nearly 5 mmHg in those drinking above 42 (women) and 50 (men) units/week, compared to those who drank between one and seven units/ week. However, a J-shaped association between SBP and alcohol was only seen in women. The risk of hypertension in women was lower amongst those drinking 1-7 units/week than in non-drinkers and in those drinking above those levels. In men no increase in risk was observed in those drinking up to 14 units/week.

These results need to be taken into account when making recommendations on how many alcoholic drinks a hypertensive person should have when weighing up risks an benefits. It is clear that a reduction in alcohol intake reduces blood pressure and hence cardiovascular risk.

In this study, the risks of hypertension for both men and women were highest in those who exceeded weekly guidelines, especially if they also exceeded daily limits. Hence heavy drinkers should be encouraged to reduce their amount of alcohol consumption and would benefit from a reduction to between one and seven units/week. However, stopping drinking altogether may not be beneficial.

Download Full Report (PDF)

Source: Daily Dose
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Population based latent class analysis of drinking behaviour: related psychological problems and cognitive impairment

F i n d i n g s
Latent class analyses were carried out based on the Alcohol Use Disorder Test (AUDIT). Analyses were performed on data from participants in the second “Psychiatric Morbidity Among Adults living in Private Households, 2000” survey (N=7849).

Six classes were found to adequately explain the AUDIT scores. These were labelled as -

• Class 1 Heavy consumption with multiple negative consequences (n=406) 5.7%
• Class 2 Heavy consumption with negative consequences (n=461) 6.4%
• Class 3 Moderate/heavy consumption (n=2369) 25.7%
• Class 4 Moderate consumption (n= 2921) 38.5%
• Class 5 Very mild consumption with negative consequences (n=574) 7.4%
• Class 6 Baseline/Mild consumption (n=1118) 16.3%

Poor mental health status was associated with membership of Class 1.

I m p l i c a t i o n s
• The findings from this study indicated that drinking behaviour cannot be simply
described along a continuum based on either frequency of drinking or
consumption of alcohol.

• Based on this analysis drinking patterns can be considered to be quantitatively
different but also qualitatively different. For instance, high levels of consumption
are not necessary for memory loss or injury to occur.

Download Full Report (PDF)

Press Release - egta signs Charter launching the EU Alcohol and Health Forum as a founding member


Brussels, 7 June 2007 – egta, the association of television and radio sales houses, joined 40
businesses and non-government organisations as founding members of the European Union’s Alcohol and Health Forum when it was launched today by EU Health Commissioner Markos Kyprianou.

Egta fully subscribes to the underlying principles laid out in the Charter and will discuss among its membership further efforts that can be carried out with the Forum’s objectives in mind.

Mr. Michel Grégoire, Secretary General of egta, signed the Forum’s Charter on behalf of egta’s 93 television and radio members, and stated that, “This involvement illustrates TV and radio sales houses’ long-held belief in promoting responsibility in all commercial communications, which of course encompasses those of alcoholic beverages. Now with the support of the European Commission and working with other stakeholders, egta intends to multiply its efforts to make sure that self-regulation is really made effective across Europe and that it properly addresses the issue of excessive alcohol consumption.”

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EU forum to fight young people's booze abuse

Published: Friday 8 June 2007 | Updated: Monday 11 June 2007

Business and NGOs in the newly set up European Alcohol and Health Forum have committed to concrete actions to protect young people against the harmful use of alcohol and irresponsible advertising and sales.

Issues

Some 40 business and non-governmental organisations signed on 7 June 2007 a Charter establishing the European Alcohol and Health Forum (AHF) aiming to take action to protect European citizens from the harmful use of alcohol.

The common commitment of stakeholders is to put special emphasis on actions to protect children and young people, to promote responsibility and to prevent irresponsible commercial communication and sales.

"It is my firm belief that in order to make any real change in the fight against alcohol-related harm, the efforts must be high not only on the public health agenda, but also on the agenda of all stakeholders, including schools, employers, NGOs, alcoholic drinks producers, distributors, the advertising and media industries, local/national authorities, member states and the EU," said Health Commissioner Markos Kyprianou.

Driven by the five key areas outlined in the EU Strategy in October 2006, the AHF "will be a very important cornerstone for the implementation of this strategy as it will focus on concrete action at European, national and local level", added Kyprianou.

The Charter foresees establishment of a Science Group, which will, at the request of the platform members, provide scientific advice and guidance on matters under discussion in the forum.

In addition, the AHF will establish two Task Forces: one on marketing communication to pursue the work of the 2006 Advertising Round Table, and one on youth-specific aspects of alcohol to examine trends in the drinking habits of young people.

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State Issue Brief - Current Research on Screening and Brief Intervention and Implications for State Alcohol and Other Drug (AOD) Systems

Screening- a preventive service provided in general health care settings- allows clinicians to intervene early in the course of disease or to prevent the disease before it can develop. Screening for alcohol problems can be used to identify individuals who may be at-risk for developing a problem with alcohol or who may already have a serious problem with alcohol.

When used in conjunction with a brief intervention or referral to a treatment program, alcohol screening can be a powerful tool for improving the public health. Individuals who screen positive for at-risk drinking should receive what is called a "brief intervention" - one or more brief counseling sessions with a health professional that focuses on motivation to reduce harmful levels of drinking. Individuals who are found to have more severe problems including alcohol abuse or dependence, should be referred to the care of addiction professionals in specialized treatment programs.

This brief will review current research in screening and brief intervention (SBI) in various settings, provide some examples of how State Alcohol and Other Drug (AOD) Agencies have implemented SBI programs, and discuss the implications for State AOD systems.

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Neurobiology of Addiction to Alcohol


Why is it that recovering persons with alcoholism should not drink near-beer (beer with little or no alcohol)?

...Hank had been dry for several weeks thanks to a radical withdrawal program, but a simple walk past Pete's Tavern on any given night almost erased his will to abstain. During the daytime he did not feel a craving for alcohol, but when he passed the bar in the evening--when he saw the warm light through the windows and heard the glasses clinking--he would be sorely tempted to run inside for a beer. Addiction researchers call this phenomenon "conditioned desire." If a person had always consumed alcohol in the same situation, an encounter with the familiar stimuli will make the feeling of need for the substance almost irresistible. Then, even after years of abstinence, consuming a single drink can set off a powerful longing to imbibe more and more... (link)

Is this real? How does this work?

First, is this real? On a list of AA slogans, #298 (out of 407) is "Don't hang around wet places and wet faces." (I'm sure there are many variations.) There is a reason it has become a slogan. Several reasons, actually. From Neural systems of reinforcement for drug addiction: from actions to habits to compulsion [Barry J Everitt & Trevor W Robbins, Nature Neuroscience 8, 1481 - 1489 (2005)]
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“Bedside” model for predicting an individual's risk of developing dementia

International Conference on Prevention of Dementia
Washington, D.C., June 10, 2007

Physicians currently have a variety of tools to predict the likelihood that someone will develop heart disease over the next 10 years. Deborah E. Barnes, Ph.D., M.P.H., Assistant Professor of Psychiatry at the University of California, San Francisco, and colleagues sought to develop a similar tool to predict an individual’s risk of developing dementia.

The researchers studied 3,375 subjects in the Cardiovascular Health Cognition Study who did not have dementia at the beginning of the study and determined which combination of factors most accurately predicted whether or not they would develop dementia over the next six years. They developed two models: the “best” model included all possible factors and the “bedside” model included only those factors that could be easily assessed by a physician during a clinic visit.

The factors in the “best” model included: older age, lower cognitive test scores (Modified Mini-Mental State Exam, Digit Symbol Substitution Test), low body mass index (<18), slower physical function (time to put on a button a shirt, time to walk 15 feet), history of by-pass surgery, lack of alcohol consumption, possession of 1 or more apolipoprotein E e4 alleles, evidence of enlarged ventricles or white matter disease on cerebral magnetic resonance imaging scans, and thickening of the carotid artery wall on ultrasound. The “bedside” model included older age, lower cognitive test scores, low body mass index (<18), slower physical function, history of by-pass surgery, and lack of alcohol consumption

The overall accuracy of the “best” model was 88 percent. Six percent of people with low scores on the “best” model developed dementia within six years compared to 25 percent of people with moderate scores and 52 percent of people with high scores. The overall accuracy of the “bedside” model was almost as good: 87 percent. Using the “bedside” model, the risk of dementia was six percent for people with low scores, 25 percent for people with moderate scores, and 54 percent for people with high scores.

“In this study population, it was possible to predict an individual’s six-year risk of developing dementia with high accuracy,” Barnes said. “The ‘best’ model was significantly better than the ‘bedside’ model, although the absolute difference between the models was relatively small. Future studies should validate these tools in other study populations.”

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