Differences in - and -Opioid Receptor Blockade Measured by Positron Emission Tomography in Naltrexone-Treated Recently Abstinent Alcohol-Dependent Subjects
Neuropsychopharmacology (2008) 33, 653–665


Blockade of brain -opioid receptor (-OR) and -opioid receptor (-OR) was investigated in recently abstinent alcohol-dependent subjects (N=21) maintained on naltrexone.

Naltrexone inhibition of [¹¹C]CAR BP was near maximal across all brain regions of interest with little variability across subjects (mean+SD% inhibition=94.9+4.9%). Naltrexone only partially inhibited the [¹¹C]MeNTI K_i and there was more variability across subjects (mean+SD% inhibition=21.1+14.49%).

Peak serum levels of naltrexone were positively correlated with % inhibition of -OR K_i in neocortex and basal ganglia. Peak serum levels of naltrexone were not correlated with % inhibition of -OR BP. Peak levels of 6--naltrexol were not significantly correlated with % inhibition of -OR BP or -OR K_i.

Thus, the FDA recommended therapeutic dose of naltrexone was sufficient to produce near complete inhibition of the -OR in recently abstinent alcohol dependent subjects. The lower percent inhibition of -OR and greater variability in -OR blockade by naltrexone across subjects may contribute to individual differences in treatment outcomes to naltrexone.

Further investigations on the relationship between individual differences in -OR blockade by naltrexone and clinical outcomes should be explored.

Read Full Abstract


Request Reprint E-Mail: eweerts@jhmi.edu
______________________________________________________________

Pharmacological Evidence for a Motivational Role of -Opioid Systems in Ethanol Dependence
Neuropsychopharmacology (2008) 33, 643–652


The purpose of this study was to test the hypothesis that activation of the dynorphin/kappa ()-opioid system has a role in the increased consumption of ethanol in dependent animals.

The effects of three opioid receptor antagonists with different effects on opioid receptors, naltrexone, nalmefene, and nor-binaltorphimine (nor-BNI), were compared in their ability to decrease ethanol self-administration in nondependent and ethanol-dependent male Wistar rats.

The results indicated that both nalmefene and naltrexone induced a significant dose-dependent decrease in the number of lever presses for ethanol in both groups of animals. However, in ethanol-dependent animals, nalmefene was significantly more effective in suppressing ethanol intake than naltrexone. Nor-BNI selectively attenuated ethanol-dependent self-administration while leaving nondependent ethanol self-administration intact. Because naltrexone is primarily selective for the -opioid receptor, and nalmefene is primarily selective for the - and -opioid receptor subtypes, the fact that nalmefene demonstrates more suppression in dependent animals suggests that opioid systems distinct from the -regulated portion may be involved in the increased drinking seen during withdrawal in dependent animals.

The results with nor-BNI confirm that -opioid receptor antagonism selectively decreases dependence-induced ethanol self-administration, which supports the hypothesis that dynorphin/-opioid systems are dysregulated in dependence and contribute to the increased drinking seen during acute withdrawal in dependent rats.

Read Full Text (PDF)
______________________________________________________________

Alcohol Preference Influences the Subthalamic Nucleus Control on Motivation for Alcohol in Rats Neuropsychopharmacology (2008) 33, 634–642;


In addition to its role in motor and attentional processes, the subthalamic nucleus (STN) has also been recently demonstrated to be involved in motivational function. Indeed, bilateral STN lesions modulate differentially the motivation for natural rewards and drugs of abuse, increasing motivation for food and decreasing motivation for cocaine in rats.

Here, we show that in outbred rats, the STN can modulate the motivation for alcohol according to alcohol preference, without affecting alcohol intake.

When performed on 'High-Drinker' rats, STN lesions enhanced the breaking point (BP) under a progressive ratio schedule of reinforcement and increased the time spent in the environment previously paired with alcohol access in the place preference paradigm. In contrast, when performed on 'Low-Drinker' rats, STN lesions decreased the BP and increased the time spent in the environment paired with water.

These results show that STN lesions enhance the motivation for alcohol in rats showing a high alcohol preference, whereas they decrease it in rats showing a low preference for alcohol

These results suggest that the STN plays a complex role in the reward circuit, that is not limited to a dissociation between motivation for natural rewards and drugs of abuse, but takes other factors, such as alcohol preference, into account.

Read Full Abstract


Request Reprint E-Mail: cbaunez@up.univ-mrs.fr
______________________________________________________

12-Step Treatment for Alcohol and Substance Abuse Revisited: Best Available Evidence Suggests Lack of Effectiveness or Harm
International Journal of Mental Health and Addiction Onlione First 11 Jan 2008


Approaches incorporating 12-Step beliefs and practices have dominated substance abuse treatment despite a lack of empirical support.

Recent claims for effectiveness relying on results from a large, multisite research project in the U.S. were re-evaluated based on critical analysis of design, methodology, and construction of outcome measures.

Contrary to claims, experimental design did not allow comparison of effectiveness of 12-Step versus cognitive–behavioral interventions but does allow evaluation of outcome measures for a single treatment intervention infused with 12-Step beliefs and teachings.

Corrected for design and methodological errors, results support estimated “remission” rates for alcohol abuse of at most 15–20% and for substance abuse of 0–15%.

Elements inherent in 12-Step practices and beliefs, including step work, run counter to accepted counseling and therapeutic factors believed to predict positive outcomes. Lack of effectiveness or outcomes less beneficial than no treatment are thus not unexpected for courses of treatment infused with 12-Step elements.

Read Full Abstract


Request Reprint E-Mail: millerz@eoni.com
_____________________________________________________________

[Commentary] DIFFERENT PATHWAYS TO KNOWLEDGE ABOUT DIFFERENT PATHWAYS TO RECOVERY: A COMMENT ON THE PEOPLE AWAKENING STUDY
Addiction 103 (2), 216–217.

The People Awakening (PA) study [1] illustrates the value of studying drinking problems in culturally diverse groups with methodologies that fit the research questions and the cultural context of inquiry. The study's qualitative, participatory methods were well suited for an initial exploration of how Alaskan Natives (AN) initiate and maintain sobriety. It is unlikely that quantitative or experimental methods would have been accepted initially or that they would have provided the rich data set upon which the authors developed their heuristic model of recovery.

The study thus exemplifies evidentiary pluralism [2], an approach that selects research methods in service of content questions, and not the other way around. Hypothesis-generating studies such as the PA project that use qualitative methods are appropriate when knowledge is developing, and the goal is to form proper questions for future research. Forcing quantitative or experimental methods prematurely can delay knowledge development, whereas well-conducted qualitative studies can propel it forward.
. . . . . .

Read Full Text (PDF)

________________________________________________________________

Editorial - About smoke and mirrors: the alcohol industry and the promotion of science
Addiction 103 (2), 175–178.


This editorial was prompted by the publication of Drinking in Context: Patterns, Interventions, and Partnerships [1], a book emerging from a collaboration between four organizations: the International Harm Reduction Association, the World Federation for Mental Health, the International Center for Alcohol Policies (ICAP) and the Institut de Recherches Scientifiques sur les Boissons. This is not the first time that some of these organizations have come together. The International Harm Reduction Association supports the ‘Dublin Principles’, which proposes working cooperation between the alcohol industry and ‘governments, and the scientific and academic community’ (http://www.icap.org/BuildingPartnerships/DublinPrinciples/tabid/249/Default.aspx). The ‘Principles’ result from a collaboration between the National College of Ireland, ICAP and the Institut de Recherches, which is also a participant in the creation of the ‘Principles’. These two latter organizations acknowledge their sponsorship by the alcohol industry.

The book is organized into 10 chapters, addressing drinking patterns, assessment of drinking, targeted and tailored interventions, alcohol-impaired driving, public disorder related to drinking, drinking by young people, interventions minimizing harm, key players and partnerships and ‘finding common ground’. Although four ‘authors’ are listed on the front cover of the book (G. Stimson, M. Grant, M. Choquet & P. Garrison), each from one of the partnering organizations, 22 other individuals are identified as ‘contributing authors’. These come from a variety of organizations, including those already mentioned above, plus universities and the alcohol industry.

The authorship arrangement deserves some attention because it is rather unusual. Further information in the book's ‘Foreword’ indicates that there was also an ‘Editorial Advisory Group’ with 15 of the 26 authors, which met twice ‘under the chairmanship of Professor Norman Sartorius’ (who is not listed as an author). This group produced the overall plan for the book and reviewed a draft manuscript. This draft was produced under the ‘guidance’ of the main editor, Professor Stimson, who wove together the ‘many contributions, some greater, some smaller’ from the other authors. According to the Foreword, this process created a ‘sense of collective responsibility’, which ‘led to the decision not to attribute authorship of particular chapters to particular individuals’. This may have been the case, but as can be inferred from the description herein it has also resulted in a rather obfuscating process that does not seem to reflect accepted authorship attributions, which implies creative input, individual ownership and public responsibility for the contents of the chapters.

Concerns about previous attempts such as this one to promote scientific research in the alcohol field by the alcohol industry have already been identified [2]. While attempting to produce this type of ‘scientific work’, the alcohol industry continues to behave unethically [3]. Industry practices in marketing and advertising (e.g. flavored malt beverages) have been identified as a potential factor triggering an ‘industrial epidemic’ of alcohol problems [4]. Unethical behavior is also present in developing countries where profit maximization is the industry's main goal [5–7]. In the paragraphs below I try to look beyond the smoke and mirrors, to describe the apparent underlying intentions behind the book, the harms this specific effort can trigger and puzzlement at why some alcohol scientists continue to participate in these efforts.
. . . . . .

Read Full Editorial (PDF)

______________________________________________________________________________

Drinking places: Where people drink and why

Gill Valentine, Sarah L Holloway, Mark Jayne and Charlotte Knell

The links between alcohol and where people drink it in two contrasting communities.

It is well-established that attitudes to alcohol vary by social group, but there is little research on how geography affects these attitudes.

This report investigates where people drink alcohol and why in two contrasting communities, one urban and one rural. Looking at a range of drinking, from abstinence to bingeing, the project:

• explores how socio-economic processes shape local drinking cultures;
• evaluates the benefits and problems associated with alcohol use;
• examines how attitudes to and use of alcohol vary across social groupings both within and between the two communities;
• explores how attitudes have changed between generations and the impact of local history on those attitudes;
• identifies the policy implications of the local specificity of drinking cultures.

• Free PDF version

_____________________________________________________________________

Press Release - Lenihan announces new Initiative on Alcohol

Department of Justice, Equality and Law Reform

9 January 2008

The Minister for Justice, Equality and Law Reform, Mr Brian Lenihan T.D., announced today that the Government has approved his proposal to establish an Advisory Group to urgently examine key aspects of the law governing the sale and consumption of alcohol.

Membership of the Advisory Group, which will hold its first meeting within a fortnight, will report to the Minister by 31 March 2008. The membership is as follows:

· Dr Gordon Holmes (Chair);
· Chief Superintendent John Twomey, An Garda Síochána;
· Professor Ian O'Donnell, Criminologist, University College Dublin;
· Dr Declan Bedford, Specialist in Public Health, Health Services Executive;
· Mr Seamus Carroll, Department of Justice, Equality and Law Reform, and
· Mr Robbie Breen, Department of Health and Children.

The issues of concern to be examined by the Advisory Group are:

· the increase in the number of supermarkets, convenience stores and petrol stations with off-licences and the manner and conditions of sale of alcohol products in such outlets, including below unit-cost selling and special promotions;

· the increasing number of special exemption orders which permit longer opening hours which are being obtained by licensed premises around the country; and

· the use, adequacy and effectiveness of existing sanctions and penalties, particularly those directed towards combating excessive and under-age alcohol consumption.
. . . . . .

Read Full Press Release

___________________________________________________________________

Ireland: Inquiry Into Drinking Laws

By AGENCE FRANCE-PRESSE

Published: January 10, 2008

Justice Minister Brian Lenihan said he would set up an advisory group to examine current laws on the sale and consumption of alcohol and report back to him by March 31. “We have a problem with binge drinking in this country, and it is clear that this problem is adding to public disorder,” he said.
. . . . . .

Read Full Article
__________________________________________________________________

The Relationship Between Alcohol Consumption and Glycemic Control Among Patients with Diabetes: The Kaiser Permanente Northern California Diabetes Registry.
J Gen Intern Med. 2008 Jan 8 [Epub ahead of print]


Alcohol consumption is a common behavior. Little is known about the relationship between alcohol consumption and glycemic control among people with diabetes.

To evaluate the association between alcohol consumption and glycemic control

In multivariate-adjusted models, A1C values were 8.88 (lifetime abstainers), 8.79 (former drinkers), 8.90 (<0.1>/=3 drinks/day). Alcohol consumption was linearly (p < 0.001) and inversely (p = 0.001) associated with A1C among diabetes patients.

Alcohol consumption is inversely associated with glycemic control among diabetes patients. This supports current clinical guidelines for moderate levels of alcohol consumption among diabetes patients.

As glycemic control affects incidence of complications of diabetes, the lower A1C levels associated with moderate alcohol consumption may translate into lower risk for complications.

Read Full Abstract

Request Reprint E-Mail: Ameena.T.Ahmed@kp.org.
_______________________________________________________________

Pregnant women and alcohol
October 2007

Find out about women's drinking habits, alcohol-related FCEs and Fetal Alcohol Syndrome...

The media attention surrounding women and alcohol consumption has recently increased dramatically. The general message seems to be that binge drinking is on the increase in women and that they are catching up or overtaking the male population in this area.

Current government advice states that women should not drink more than 2-3 units of alcohol per day. However, the popular image generated by the media of drunken young women would suggest that this advice is not taken as seriously as it should be....

Read Full Topic Paper

Pregnant women and alcohol article: related statistical analysis (PDF)

______________________________________________________

Acamprosate: A New Medication for Alcohol Use Disorders



The Substance Abuse and Mental Health ServicesAdministration’s (SAMHSA’s) Knowledge Application Program (KAP) is pleased to announce its first online e-learning course, Acamprosate: A New Medication for Alcohol Use Disorders.

The self-paced course provides information about the use, side effects, and contraindications of acamprosate; information to discuss with clients; and a comparison of medications for alcohol use disorders. On completion of the course, users will know how to include acamprosate in a treatment plan for appropriate clients.

The course is based on the acamprosate Substance Abuse Treatment Advisory published in fall 2005. Users who successfully complete the course will receive one NAADAC-approved continuing education unit (CEU) at no cost and can print out their CEU certificate. The course is self-paced so that users can log out of the course and return at a later time to continue where they left off. If unsuccessful, users can take the course again.

Other e-learning courses in development include—
~~Prescription Medications: Misuse, Abuse, Dependence, and Addiction
~~Organizational Development: Marketing for Referral Development
~~Organizational Development: Finance
~~Organizational Development: Governance
~~Anger Management

To access the "Acamprosate: A New Medication for Alcohol Use Disorders" e-learning course, go
to:
www.kap-elearning.samhsa.gov

___________________________________________________________________

Reduced thalamic grey matter volume in opioid dependence is influenced by degree of alcohol use: a voxel-based morphometry study
Journal of Psychopharmacology, Vol. 22, No. 1, 7-10 (2008)





The aim of this study was to make a comparison of brain structure between a group of opioid-dependent subjects and healthy controls. We report the results of an `optimized' voxel-based morphometry study on a sample of nine opioid-dependent subjects with no comorbid substance misuse disorders versus 21 healthy controls. We found a significant reduction in grey matter volume of the thalamus after controlling for age and total grey matter volume. Regression analysis of substance use variables in the opioid-dependent sample shows that only level of alcohol use negatively predicts grey matter volume for this region of difference. We suggest that level of nondependent alcohol use could influence reduced thalamic grey matter volume in opioid-dependent subjects.

Read Full Abstract

Request Reprint E-Mail: alastair.reid @bristol.ac.uk
___________________________________________________________

Acamprosate supports abstinence, Naltrexone prevents excessive drinking: evidence from a meta-analysis with unreported outcomes
Journal of Psychopharmacology, Vol. 22, No. 1, 11-23 (2008)

Two pharmacological agents have repeatedly been shown to be efficacious for relapse prevention in alcohol dependence: The putative glutamate-antagonist acamprosate and the opioid-antagonist naltrexone.

Clinical evidence for both drugs is based on various outcome criteria. Whereas for acamprosate primarily abstinence maintenance has been demonstrated, studies with naltrexone have mostly emphasised the prevention of heavy drinking.

The remaining effects of both drugs are not always reported; accordingly the corresponding database is fragmentary.

Thus, the primary objective of the present meta-analysis was to complete the efficacy profiles for acamprosate and naltrexone and to compare them with each other. Unreported results, requested from the study investigators and the drug manufacturers, were integrated in the computation of effect sizes.

For the meta-analysis, emphasis was placed on the conceptual distinction between having a first drink and returning to heavy drinking. Naltrexone was found to have a significant effect on the maintenance of abstinence as well as the prevention of heavy drinking. Acamprosate was shown only to support abstinence; it did not influence alcohol consumption after the first drink.

When the efficacy profiles of the two drugs were compared, acamprosate was found to be more effective in preventing a lapse, whereas naltrexone was better in preventing a lapse from becoming a relapse.

The superiority of either one drug or over the other one cannot be determined as a general rule, it rather depends on the therapeutic target. Benefits in the treatment of alcohol dependence might be optimized by matching the efficacy profiles of specific antidipsotropics with the motivational status of alcohol-dependent patients.

Read Full Abstract

Request Reprint E-Mail: roesner@ift.de

_________________________________________________________

Safe, Sensible, Social: Alcohol strategy local implementation toolkit
Home Ofice, Department of Health, Department for Children, Schools and Families
January 2008

This toolkit is a resource to help local teams develop strategies to address alcohol-related crime, ill health and other harm in line with Safe, Sensible, Social. The next steps in the National Alcohol Strategy.

It has been written specifically to help alcohol leads and others within local authorities, primary care trust (PCTs), children's services and delivery partnerships such as Crime and Disorder Reduction Partnerships (CDRPs) and Drug and Alcohol Action Teams (DAATs) - the people most likely to be responsible for developing and delivering alcohol strategies locally.

It will also be useful to individual agencies tackling alcohol misuse.

Download Full Report (PDF)

___________________________________________________________

Design of Electrochemical Biosensor Systems for the Detection of Specific DNA Sequences in PCR-Amplified Nucleic Acids Related to the Catechol-O-methyltransferase Val108/158Met Polymorphism Based on Intrinsic Guanine Signal
Anal. Chem., ASAP Article 10.1021/ac071407q S0003-2700(07)01407-2 Web Release Date: January 9, 2008

Psychiatric disorders are common and complex diseases that show polygenic and multifactorial heredity. A single nucleotide polymorphism (Val108/158Met) in the catechol-O-methyl transferase (COMT) gene is related to many psychiatric disorders such as schizophrenia, alcoholism, bipolar disorder, and obsessive-compulsive disorder. Schizophrenia is a complex disorder and a single nucleotide polymorphism (Val108/158Met) at the COMT gene is related to schizophrenia susceptibility.

A novel hybridization-based disposable electrochemical DNA biosensor for the detection of a common functional polymorphism in the COMT gene from polymerase chain reaction (PCR) amplicons has been described without using an external label.

This developed technology combined with a disposable carbon graphite electrode and differential pulse voltammetry was performed by using short synthetic oligonucleotides and PCR amplicons in length 203 bp to measure the change of guanine oxidation signal obtained at ~+1.0 V after DNA hybridization between probe and target (synthetic target or denatured PCR samples).

COMT-specific oligonucleotides were immobilized onto the carbon surface with a simple adsorption method in two different modes: (a) Guanine-containing targets were attached or (b) inosine-substituted probes were attached onto an electrode.

By controlling the surface coverage of the target DNA, the hybridization event between the probes and their synthetic targets or specific PCR products was optimized. The wild-type or polymorphic allele-specific probes/targets were also interacted with an equal amount of noncomplementary and one-base mismatch-containing DNAs in order to measure the sensor selectivity.

The decrease or appearance in the intrinsic guanine signal simplified the detection procedure and shortened the assay time because protocol eliminates the label-binding step. The nonspecific binding effects were minimized by using sodium dodecyl sulfate with different washing methods.

The Val108/158Met COMT genotype detection were performed with real samples containing wild-type (healthy controls), polymorphic (mutant type), and heterozygous PCR products. The detection limit (S/N = 3) of the biosensor was 2.44 pmol of target sequence in the 30-L samples.

Analytical performance of the sensor is described, along with future prospects.


Read Full Abstract


Request Reprint E-Mail: ariksoysald@yahoo.com
___________________________________________________________

Increased drinking in a metropolitan city in China: a study of alcohol consumption patterns and changes
Addiction (OnlineEarly Articles) 9 Jan 2008

To investigate alcohol drinking among urban Chinese and any changes between 2002 and 2005.

Nearly three-quarters (90% for men and 55% for women) were current alcohol drinkers in 2005, and the prevalence of drinking alcohol had increased significantly since 2002 among both men and women; the largest increases occurred in the younger group (18–19 years) and among older women. There was no change in the frequency of drinking, the average quantities consumed by drinkers and the volume of absolute alcohol consumed by drinkers over this 3-year period. However, reflecting the increased prevalence of drinkers, the median volumes of absolute alcohol consumed in the sample as a whole had increased significantly. Older males were more likely to be categorized as larger-quantity drinkers: 30–65-year-old men accounted for 63%. There was also an increase over time in the proportion of larger-quantity drinkers: the proportion of male larger-quantity drinkers increased from 27% in 2002 to 35% in 2005.

In the urban setting of Wuhan, over the time-period 2002–05, there was an increase in prevalence of drinkers, particularly among younger people and older women. The average frequency and quantities consumed by drinkers did not change over this period; among drinking men the volumes of alcohol consumed were comparable to those in much more saturated commercial alcohol markets. The results did, however, show an increase over time in the proportion of older men who were engaged in heavier drinking and, in 2005, the proportion exceeded that in more saturated markets.

These data suggest that, given the relatively high levels of consumption among established drinking groups, increases in the prevalence of drinkers over time may result in increases in harm if effective policies are not implemented.

Read Full Abstract

Request Reprint E-Mail: s.casswell@massey.ac.nz

________________________________________________________________

Conference Report - Recovery: Patients, Families, Communities
October 11-14, 2007; New Orleans, Louisiana
Posted 12/28/2007




The theme of the 2007 Institute on Psychiatric Services annual conference was "Recovery: Patients, Families, Communities." In this conference report, a workshop, a lecture, and a symposium are summarized, each highlighting the increasingly discussed topic of recovery -- a subject that originated from the field of addictions and has taken hold in many areas of psychiatry. As applied to other areas of mental health (and illness), the recovery paradigm expands considerably from a simpler concept of remission of symptoms and change in behaviors.
. . . . . .

Read Full Article
______________________________________________________________________

Recurring Ethanol Exposure Induces Disinhibited Courtship in Drosophila
PLoS ONE 3(1): e1391

Alcohol has a strong causal relationship with sexual arousal and disinhibited sexual behavior in humans; however, the physiological support for this notion is largely lacking and thus a suitable animal model to address this issue is instrumental.

We investigated the effect of ethanol on sexual behavior in Drosophila. Wild-type males typically court females but not males; however, upon daily administration of ethanol, they exhibited active intermale courtship, which represents a novel type of behavioral disinhibition.

The ethanol-treated males also developed behavioral sensitization, a form of plasticity associated with addiction, since their intermale courtship activity was progressively increased with additional ethanol experience.

We identified three components crucial for the ethanol-induced courtship disinhibition: the transcription factor regulating male sex behavior Fruitless, the ABC guanine/tryptophan transporter White and the neuromodulator dopamine. fruitless mutant males normally display conspicuous intermale courtship; however, their courtship activity was not enhanced under ethanol. Likewise, white males showed negligible ethanol-induced intermale courtship, which was not only reinstated but also augmented by transgenic White expression. Moreover, inhibition of dopamine neurotransmission during ethanol exposure dramatically decreased ethanol-induced intermale courtship.

Chronic ethanol exposure also affected a male's sexual behavior toward females: it enhanced sexual arousal but reduced sexual performance.

These findings provide novel insights into the physiological effects of ethanol on sexual behavior and behavioral plasticity.

Read Full Article (PDF)
_____________________________________________________________

A comparison of U.S. jail inmates and the U.S. general population with Diagnostic and Statistical Manual of Mental Disorders IV alcohol use disorders: sociodemographic and symptom profiles
Alcohol Article in Press, Corrected Proof 7 Jan 2008


The objective of this study was to compare sociodemographic and symptom profiles between U.S. jail inmates and the U.S. general population with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorder.

Data for the study were derived from two large nationally representative surveys, the 2002 Survey of Inmates in Local Jails and the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions.

U.S. inmates were significantly more likely (P < .007) to be younger, male, Black or Hispanic, to have lower education, and to be separated/divorced/widowed or never married relative to their U.S. general population counterparts.

Inmates were also more likely to have more severe alcohol abuse and dependence.

Implications of this study are discussed in terms of meeting the unique alcohol treatment needs of U.S. jail inmates including implementation of more intensive alcohol treatment and intervention programs targeting specific needs of inmates with alcohol use disorder as revealed from unique sociodemographic profiles.


Read Full Abstract

Request Reprint E-Mail: xyrloc@yahoo.com
___________________________________________________________

How Do Experiences In Iraq Affect Alcohol Use Amongst Male Uk Armed Forces Personnel?
Occup Environ Med. Published Online First: 4 January 2008.

We have reported a statistically significant association between alcohol use and deployment to the 2003 Iraq War. This paper assesses the occupational factors and deployment experiences associated with "heavy drinking" in regular UK Servicemen deployed to Iraq in the first phase of the 2003 Iraq War (Operation TELIC 1; the military codename for the conflict in Iraq).

After adjustment for socio-demographic and military factors, and the presence of psychological distress, "heavy drinkers" were more likely to have had major problems at home during (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.04-1.70) and following their deployment (OR 1.68, 95% CI 1.32-2.14).

Being deployed with their parent unit (OR 1.28, 95% CI 1.02-1.61), medium to high in-theatre unit comradeship (medium: OR 1.35, 95% CI 1.04-1.77; high: OR 1.35; 95% CI 1.02-1.79), and poor unit leadership (OR 1.78, 95% CI 1.37-2.31), were also associated with heavy drinking.

Deployment experiences and problems at home during and following deployment, as well as the occupational milieu of the unit, influence personnel’s risk of heavy drinking.

Read Full Abstract

Request Reprint E-Mail: n.fear@iop.kcl.ac.uk.

_______________________________________________________________________

Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study
PLoS Med 5(1): e12

There is overwhelming evidence that behavioural factors influence health, but their combined impact on the general population is less well documented. We aimed to quantify the potential combined impact of four health behaviours on mortality in men and women living in the general community.

We examined the prospective relationship between lifestyle and mortality in a prospective population study of 20,244 men and women aged 45–79 y with no known cardiovascular disease or cancer at baseline survey in 1993–1997, living in the general community in the United Kingdom, and followed up to 2006. Participants scored one point for each health behaviour: current non-smoking, not physically inactive, moderate alcohol intake (1–14 units a week) and plasma vitamin C >50 mmol/l indicating fruit and vegetable intake of at least five servings a day, for a total score ranging from zero to four.

After an average 11 y follow-up, the age-, sex-, body mass–, and social class–adjusted relative risks (95% confidence intervals) for all-cause mortality(1,987 deaths) for men and women who had three, two, one, and zero compared to four health behaviours were respectively, 1.39 (1.21–1.60), 1.95 (1.70–-2.25), 2.52 (2.13–3.00), and 4.04 (2.95–5.54) p <>

Four health behaviours combined predict a 4-fold difference in total mortality in men and women, with an estimated impact equivalent to 14 y in chronological age.

Read Full Article (PDF)

______________________________________________________________

Specificity of Bipolar Spectrum Conditions in the Comorbidity of Mood and Substance Use Disorders
Results From the Zurich Cohort Study
Arch Gen Psychiatry. 2008;65(1):47-52.

Although an association between mood disorders and substance use disorders has been well established, there is a lack of long-term prospective data on the order of onset and subtypes of mood disorders associated with specific substances and their progression.

To estimate the respective risks posed by subtypes of mood disorders or bipolar spectrum conditions for the subsequent development of substance use disorders.

Individuals having manic symptoms were at significantly greater risk for the later onset of alcohol abuse/dependence, cannabis use and abuse/dependence, and benzodiazepine use and abuse/dependence. Bipolar II disorder predicted both alcohol abuse/dependence and benzodiazepine use and abuse/dependence. In contrast, major depression was predictive only of later benzodiazepine abuse/dependence.

In comparison with major depression, bipolar II disorder was associated with the development of alcohol and benzodiazepine use and disorders. There was less specificity of manic symptoms that tended to predict all levels of the substances investigated herein.

The different patterns of association between mood disorders and substance use trajectories have important implications for prevention and provide lacking information about underlying mechanisms.

Read Full Abstract

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

____________________________________________________________

Editorial - The Alcohol Hangover–A Puzzling Phenomenon
Alcohol and Alcoholism Advance Access published online on January 8, 2008

The alcohol hangover develops when blood alcohol concentration (BAC) returns to zero and is characterized by a feeling of general misery that may last more than 24 h. It comprises a variety of symptoms including drowsiness, concentration problems, dry mouth, dizziness, gastro-intestinal complaints, sweating, nausea, hyper-excitability, and anxiety.

The alcohol hangover is an intriguing issue since it is unknown why these symptoms are present after alcohol and its metabolites are eliminated from the body.

Although numerous scientific papers cover the acute effects of alcohol consumption, researchers largely neglected the issue of alcohol hangover. This lack of scientific interest is remarkable, since almost everybody is familiar with the unpleasant hangover effects that may arise the day after an evening of excessive drinking, and with the ways these symptoms may affect performance of planned activities.

Read Full Abstract


Request Reprint E-Mail: j.c.verster@uu.nl
_________________________________________________________________

Ethanol Acutely Stimulates Islet Blood Flow, Amplifies Insulin Secretion, and Induces Hypoglycemia via Nitric Oxide and Vagally Mediated Mechanisms
Endocrinology Vol. 149, No. 1 232-236

Hypoglycemia induced by alcohol ingestion is a well-known problem in diabetic patients. However, the mechanisms underlying this phenomenon have largely remained elusive.

Because insulin secretion in vivo can be rapidly tuned by changes in pancreatic microcirculation, we evaluated the influence of acute alcohol administration on pancreatic islet blood flow (IBF), and dynamic changes in insulin secretion and glycemia in the rat. Ethanol (10%) or saline was iv injected as a bolus into Wistar rats, yielding serum ethanol concentrations of approximately 8 mmol/liter. Measurements of pancreatic blood flow (PBF) were performed by a microsphere technique in combination with a freeze-thawing technique after 10-min injection.

Ethanol preferentially and significantly increased pancreatic IBF approximately 4-fold, whereas not influencing whole PBF. The alcohol also augmented late-phase insulin secretion and induced late hypoglycemia upon ip glucose tolerance tests. The nitric oxide synthase inhibitor N-w-nitro-L-arginine methyl ester and atropine prevented the increased pancreatic IBF, enhanced insulin secretion, and hypoglycemia evoked by ethanol.

Thus, our findings demonstrate that ethanol acutely exerts substantial influences on pancreatic microcirculation by evoking a massive redistribution of PBF from the exocrine into the endocrine part via mechanisms mediated by nitric oxide and vagal stimuli, augmenting late-phase insulin secretion, and thereby evoking hypoglycemia.

This effect may in part underlie the well-known hypoglycemic properties of alcohol in diabetic patients or in alcoholics with hepatic failure.

Read Full Abstract

Reprint Request E-Mail: ake.sjoholm@sodersjukhuset.se
__________________________________________________________________