Model-Based Appraisal of Alcohol Minimum Pricing and Off-Licensed Trade Discount Bans in Scotland: A Scottish adaptation of the Sheffield Alcohol Policy Model version 2

From June to September 2008, the Scottish Government consulted on a range of proposals aimed at reducing levels of alcohol-related harm. The proposals included taking action to restrict promotions of alcoholic beverages and introducing a minimum retail price for a UK unit of alcohol.

Simultaneously to the Scottish consultation, the University of Sheffield was appraising pricing and promotion policy options as part of a programme of work funded by the UK Department of Health (DH) Policy Research Programme. The results of this research were published by DH in December 2008 and relate specifically to the English population.

On 2 March 2009, the Scottish Government announced specific actions in reaction to the consultation responses received, including modifications to the existing licensing regulations to prohibit discounting of alcohol and to introduce a minimum retail price per unit of alcohol. The initial threshold for the minimum price is yet to be decided, and requires in part further information on the likely impacts of such an intervention applied in a Scottish context. The xisting modelling infrastructure developed for DH – known as the Sheffield Alcohol Policy model – provides a strong platform for such an investigation and so the University of Sheffield was asked to adapt the English version of the model to a Scottish population.

The following set of policies has been prioritised for analysis:

1. What are the likely effects of introducing a minimum unit price on alcohol consumption, sales, health, crime and workplace harms in Scotland?

2. What are the likely effects of introducing a ban on price-based promotions in the offlicensed trade in Scotland?

3. What are the likely effects of introducing a minimum unit price simultaneously with a ban on price-based promotions in the off-licensed trade in Scotland?

The Sheffield Alcohol Policy Model version 2 has been adapted to a Scottish context incorporating Scotland-specific data on levels of alcohol consumption, the prices paid by population sub-groups for different categories of alcohol and the preferences for off-licensed trade versus on-licensed trade purchasing. The model also includes Scottish data on the prevalence of alcohol-related diseases, alcohol-attributable fractions for acute conditions, the prevalence of alcohol-related crime, and levels of absenteeism and unemployment.

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Alcohol consumption and carotid artery structure in Korean adults aged 50 years and older

BMC Public Health 2009, 9:358

Epidemiologic studies of the association between alcohol consumption and carotid artery structure have reported conflicting results. We investigated the association between alcohol consumption and carotid atherosclerosis by evaluating the effects of alcohol intake on carotid artery structure.

The results of our study indicate that alcohol consumption is inversely related to carotid IMT and positively related to carotid plaques in men, but not women. However, alcohol intake is positively associated with CCA-diameter in both men and women. Additional large population-based prospective studies are needed to confirm the effects of alcohol consumption on carotid artery structure

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Liquor laws blamed for drink harm
JULIA MEDEW

September 23, 2009

A BIG rise in alcohol-related injuries and illnesses reported in Victoria has been linked by a researcher to the state's liberal liquor licensing.

The number of people in hospital for alcohol-related injuries and diseases in Victoria jumped 77 per cent between 1995 and 2006 - compared with a 34 per cent increase nationally, according to a report from the National Drug Research Institute.

The most common causes of admissions were alcohol dependence, falls, assaults, attempted suicide and injuries sustained in road accidents.

The report's author, Associate Professor Tanya Chikritzhs, said the big rise in alcohol-related hospital admissions in Victoria was consistent with a large increase in the number of licensed premises, from 2000 to 24,000 in the same period. . . . . . .

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Media Release - Alcohol-caused death rates decline but hospitalisations keep on rising

The number of Australians hospitalised for preventable injuries and illnesses caused by risky drinking has risen by a third in a decade, and there are indications that this trend is set to continue, putting huge pressure on the healthcare system, now and in the future.

New research from the National Drug Research Institute (NDRI) found that alcohol continues to be a major preventable cause of death, injury and disease for many Australians. Risky or high risk alcohol consumption caused the death of 32,696 Australians aged 15 and older in the 10 years from 1996 to 2005, and 813,072 Australians were hospitalised due to alcohol-caused injury and disease over the same period.

While the death rate due to alcohol has declined in most regions, the number of hospitalisations from alcohol-caused injury and disease has risen substantially in every state and territory. The major cause of alcohol-attributable death was alcoholic liver cirrhosis and the leading cause of hospitalisations was alcohol dependence.

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Trends in estimated alcohol-attributable deaths and hospitalisations in Australia, 1996-2005

National Alcohol Indicators, Bulletin No.12. Perth: National Drug Research Institute, Curtin University of Technology.

This bulletin shows trends in estimated population adjusted rates of deaths and hospitalisations attributable to risky/high risk alcohol consumption (based on NHMRC 2001 drinking guidelines) across all jurisdictions for a period of 10 years (1996-2005). The rates shown here are for adults (15+ years) and are based on the aetiologic fraction method for quantifying alcohol-attributable mortality and morbidity (English et al. 1995; WHO 2000). As such, these rates are considered estimates of deaths and hospitalisations ‘caused’ as opposed to the more loosely defined estimates of ‘alcohol-related’ events. Rates have been directly age-standardised to the 2006 national population aged 15 years and older (ABS 2008).

This Bulletin also includes estimates of non-alcohol-attributable deaths and hospitalisations as a comparison measure (page 4). Nonalcohol- attributable conditions were those not currently considered to be attributable to either alcohol or tobacco use (changes in population tobacco use may influence underlying mortality/morbidity trends). Non-alcohol-attributable conditions include for example; pancreatic cancer, unspecified dementia, and cataracts but exclude tobacco attributable conditions such as lung cancer, peptic ulcer, chronic bronchitis, peripheral vascular disease, renal pelvic cancer and bladder cancer.

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AFL is on the case to end binge drinking
PIPPA GRANGE September 26, 2009

RECENT international statistics suggest that alcohol kills more than six times more people than all other drugs combined. In Australia it causes about 3000 deaths and 65,000 hospitalisations every year. Between 1998 and 2005 there was a 39 per cent increase in presentations for behavioural or mental health issues associated with alcohol.

Dr Andrew Rochford, registrar at Sydney's North Shore Hospital, reports that as much as 50 per cent of weekend night-time presentations in emergency are alcohol related and they take up to 70 per cent of staff time. The estimated cost of alcohol-related social issues runs to more than $15 billion annually.

Excessive drinking creates financial, relationship, physical and mental health, cultural and social costs - and they are unacceptable. Risky drinking is a problem in Australia.

The kind of risky drinking we see in AFL is binge drinking. The home-and-away season is about getting the absolute best out of each player as an elite athlete and there is very little place for hangovers, dehydration or reduced training capacity caused by alcohol. The game is more ruthless and more professional than ever, and each man is accountable to his teammates and to his jumper. . . . . . .

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The NSDUH Report - Suicidal Thoughts and Behaviors among Adults

In 2008, an estimated 8.3 million adults aged 18 or older (3.7 percent of the adult population) had serious thoughts of suicide in the past year; 2.3 million (1.0 percent) made a suicide plan; and, 1.1 million (0.5 percent) attempted suicide.

Young adults aged 18 to 25 were more likely than adults aged 26 to 49 and those aged 50 or older to have had serious thoughts of suicide (6.7 vs. 3.9 and 2.3 percent, respectively), to have made any plans for suicide (1.9 vs. 1.1 and 0.7 percent), and to have attempted suicide (1.2 vs. 0.4 and 0.3 percent).

Of the adults who attempted suicide in the past year, 62.3 percent received medical attention for their suicide attempts, and 46.0 percent stayed overnight or longer in a hospital for their suicide attempts.

Rates of suicidal behaviors were also significantly higher among those with a past year substance use disorder than among those without a substance use disorder.

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Impact of Tryptophan Metabolism on the Vulnerability to Alcohol-Related Blackouts and Violent Impulsive Behaviours

Alcohol and Alcoholism Advance Access published online on September 16, 2009

We examined (1) the association of SLC6A4 genotypes and alcohol dependence (AD) in a sample of alcoholics; (2) the validity of lifetime occurrence of blacked-out violent impulsive behaviour (BOVIB) during binge drinking bouts as a criterion for subtyping AD patients and (3) a mechanistic hypothesis for BOVIB involving tryptophan-2,3-dioxygenase (TDO) activity.

BOVIB+ patients showed significantly higher scores on depression, anxiety and character scales but no significant association was found between SLC6A4 polymorphisms and BOVIB. Patients with a history of BOVIB (BOVIB+ subgroup) differed from those exempt from such episodes (BOVIB– subgroup) for TDO activity response to OTL assessed by the Kyn:Trp ratio (P = 0.043) and the slope of concentration increase ratio (SCIR) of serum Kyn (P = 0.043).

Put together, these findings support the validity of the BOVIB criterion to differentiate a sub-group of vulnerable AD subjects and suggest that OTL may help to concurrently define a specific endophenotype.

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Sex Differences in Caffeine Neurotoxicity Following Chronic Ethanol Exposure and Withdrawal

Alcohol and Alcoholism Advance Access published online on September 16, 2009

Caffeine is a central nervous system stimulant that produces its primary effects via antagonism of the A1 and A2A adenosine receptor subtypes. Previous work demonstrated a sex difference in neurotoxicity produced by specific adenosine A1 receptor antagonism during ethanol withdrawal (EWD) in vitro that was attributable to effects downstream of A1 receptors at NMDA receptors.

The current studies were designed to examine the effect of non-specific adenosine receptor antagonism with caffeine during ethanol withdrawal on hippocampal toxicity in cultures derived from male and female rats.

Twenty-four-hour exposure to caffeine during EWD produced significant toxicity in the pyramidal cell layer of the CA3 region in male and female cultures, though toxicity in the granule cell layer of the DG and pyramidal cell layer of the CA1 region was observed only in female cultures. Greater sensitivity of the female slice cultures to toxicity upon caffeine exposure after prolonged ethanol exposure is consistent with previous studies of effects of a specific A1 receptor antagonism during EWD on toxicity and indicate that this effect is independent of the hormonal milieu.

Together, these data suggest that the A1 receptor subtype is predominant in mediating caffeine's neurotoxic effects during EWD. These findings demonstrate the importance of considering gender/sex when examining neuroadaptive changes in response to ethanol exposure and withdrawal.

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One for the road? Film forces France to admit its drinking problem

Jason Burke in Paris
The Observer, Sunday 27 September 2009

One for the Road, the real-life story of a journalist's battle with alcohol, sparks debate over the country's self-image as a nation of moderate wine-lovers

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Suicide and Alcohol: Do Outlets Play a Role?

Alcoholism: Clinical and Experimental Research Early View 17 Sep 2009

The purpose of this study was to determine whether the number of alcohol outlets in local and adjacent areas, in particular bars, was related over time to completed suicide and suicide attempts. There is evidence both from studies of individuals and time series aggregate studies, mostly at the national level, of substantial alcohol involvement in suicide, but no small-area, longitudinal studies have been carried out.

The present study is the first that is both longitudinal and based on a large number of small spatial units, California zip codes, a level of resolution permitting analysis of the relationship between local alcohol access and suicide rates over time.

Bar densities in particular appear related to suicide, meaning, because this is an aggregate-level spatial analysis, that suicides, both attempted and completed, occur at greater rates in rural community areas with greater bar densities. Because the suicide rate is highest in rural areas, this study suggests that although the number of completed and attempted suicides is no doubt greater in absolute numbers in urban areas, the suicide rate, both completed and attempted, is greater in rural areas, which draws attention, perhaps much needed, to the problems of rural America.

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Ethanol Is Self-Administered Into the Nucleus Accumbens Shell, But Not the Core: Evidence of Genetic Sensitivity

Alcoholism: Clinical and Experimental Research Early View 17 Sep 2009

A previous study indicated that selectively bred alcohol-preferring (P) rats self-administered ethanol (EtOH) directly into the posterior ventral tegmental area at lower concentrations than Wistar rats. The present study was undertaken to determine involvement of the nucleus accumbens (Acb) with EtOH reinforcement, and a relationship between genetic selection for high alcohol preference and sensitivity of the Acb to the reinforcing effects of EtOH.

The present results indicate that the AcbSh, but not AcbC, is a neuroanatomical structure that mediates the reinforcing actions of EtOH. The data also suggest that, compared to Wistar rats, the AcbSh of P rats is more sensitive to the reinforcing effects of EtOH.

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Long-Term Effects of Minimum Drinking Age Laws on Past-Year Alcohol and Drug Use Disorders

Alcoholism: Clinical and Experimental Research Early View 23 Sep 2009

Many studies have found that earlier drinking initiation predicts higher risk of later alcohol and substance use problems, but the causal relationship between age of initiation and later risk of substance use disorder remains unknown.

Exposure to a lower minimum legal purchase age was associated with a significantly higher risk of a past-year alcohol or other substance use disorder, even among respondents in their 40s or 50s. However, this association does not seem to be explained by age of initiation of drinking, per se. Instead, it seems plausible that frequency or intensity of drinking in late adolescence may have long-term effects on adult substance use patterns.

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Differential actions of ethanol and trichloroethanol at sites in the M3 and M4 domains of the NMDA receptor GluN2A (NR2A) subunit

British Journal of Pharmacology Early View 25 Sep 2009

Alcohol produces its behavioural effects in part due to inhibition of N-methyl-d-aspartate (NMDA) receptors in the CNS. Previous studies have identified amino acid residues in membrane-associated domains 3 (M3) and 4 (M4) of the NMDA receptor that influence ethanol sensitivity. In addition, in other alcohol-sensitive ion channels, sedative-hypnotic agents have in some cases been shown to act at sites distinct from the sites of ethanol action. In this study, we compared the influence of mutations at these sites on sensitivity to ethanol and trichloroethanol, a sedative-hypnotic agent that is a structural analogue of ethanol.

Ethanol sensitivity of mutants at GluN2A(Ala825) was not correlated with any physicochemical measures tested. Trichloroethanol sensitivity was altered in two of three ethanol-insensitive mutant GluN2A subunits: GluN2A(Phe637Trp) in M3 and GluN2A(Ala825Trp) in M4, but not GluN2A(Met823Trp). Trichloroethanol sensitivity decreased with increasing molecular volume at Phe637 or increasing hydrophobicity at Ala825 and was correlated with ethanol sensitivity at both sites.

Evidence obtained to date is consistent with a role of GluN2A(Ala825) as a modulatory site for ethanol and trichloroethanol sensitivity, but not as a binding site. Trichloroethanol appears to inhibit the NMDA receptor in a manner similar, but not identical to, that of ethanol.

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Applying the Attention-Allocation Model to the Explanation of Alcohol-Related Aggression: Implications for Prevention

Substance Use & Misuse, Volume 44, Issue 9 & 10 July 2009 , pages 1263 - 1279

The primary purpose of this article is to apply the attention-allocation model (AAM; Steele and Josephs, 1990) to the explanation, as well as the prevention, of alcohol-related violence.

The AAM contends that alcohol has a “myopic” effect on attentional capacity that presumably facilitates aggression by narrowing attentional focus on the most salient provocative cues that are naturally present in hostile situations, rather than on less salient inhibitory cues.

Data are presented to demonstrate support for the AAM with regard to alcohol-related aggression. The model has also been expanded to suggest some intermediary mechanisms that may account for how distracting attention away from provocative cues might be involved in the reduction of aggression.

Finally, a number of practical suggestions are put forth regarding how the AAM can be applied to the prevention of intoxicated aggression.

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Dimensions of Problem Drinking among Young Adult Restaurant Workers

The American Journal of Drug and Alcohol Abuse, Volume 35, Issue 5 September 2009 , pages 329 - 333

Nationwide surveys identify food service workers as heavy alcohol users. Objectives: This article analyzes dimensions and correlates of problem drinking among young adult food service workers.

Hazardous alcohol consumption patterns were seen in 80% of men and 64% of women. Multivariate analysis showed that different dimensions of problem drinking measured by the AUDIT were associated with workers' demographic characteristics, smoking behaviour, and job category.

These findings offer evidence of extremely high rates of alcohol misuse among young adult restaurant workers

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WHO releases alcohol strategy guidance for European states

The World Health Organisation (WHO) has released the Handbook for action to reduce alcohol related harm. The handbook is aimed at policy makers to help them 'review, adjust or strengthen their alcohol action plans and explores ten areas for action'. WHO has also released the supporting Evidence for the effectiveness and cost–effectiveness of interventions to reduce alcohol-related harm. . . . . .

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Ethanol seeking triggered by environmental context is attenuated by blocking dopamine D1 receptors in the nucleus accumbens core and shell in rats.

Psychopharmacology (Berl). 25 Sep 2009

Conditioned behavioral responses to discrete drug-associated cues can be modulated by the environmental context in which those cues are experienced, a process that may facilitate relapse in humans. Rodent models of drug self-administration have been adapted to reveal the capacity of contexts to trigger drug seeking, thereby enabling neurobiological investigations of this effect.

We tested the hypothesis that dopamine transmission in the nucleus accumbens, a neural structure that mediates reinforcement, is necessary for context-induced reinstatement of responding for ethanol-associated cues.

These findings suggest a critical role for dopamine acting via D1 receptors in the nucleus accumbens in the reinstatement of responding for ethanol cues triggered by placement into an ethanol-associated context.

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Request Reprint E-Mail: nchaudhri@gallo.ucsf.edu

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Transcription factor AP2 beta involved in severe female alcoholism

Brain Research Article in Press 22 Sep 2009

Susceptibility to alcoholism and antisocial behavior exhibits an evident link to monoaminergic neurotransmission. The serotonin system in particular, which is associated with regulation of mood and behavior, has an influence on personality characters that are firmly connected to risk of developing alcoholism and antisocial behavior, such as impulsiveness, and aggression.

The transcription factor TFAP2b has repeatedly been shown to be involved in monoaminergic transmission, likely due to a regulatory effect on genes that are fundamental to this system, e.g. monoamine oxidase type A, and the serotonin transporter. Recent research has identified a functional polymorphism in the gene encoding TFAP2B that regulates its level of expression.

The results showed that parental alcohol misuse was significantly more common among the alcoholic females, and also that parental alcohol misuse was associated with a reduction in age of alcohol debut. We also addressed the question of whether a functional TFAP2b polymorphism was associated with alcoholism.

Results showed that the high-functioning allele was significantly more common among the female alcoholics, compared to the non-alcoholic controls. Furthermore, the results also indicated that psychosocial factors, in terms of parental alcohol misuse, depression or psychiatric disorder, had an influence on the association. It was observed that the genetic association was restricted to the subset of cases that had not experienced these negative psychosocial factors.

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Request Reprint E-Mail: niklas.nordquist@neuro.uu.se

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New TAP on Implementing Change in Substance Abuse Treatment

Technical Assistance Publication (TAP) 31: Implementing Change in Substance Abuse Treatment Programs provides guidance on integrating evidence-based practices (EBPs) into substance abuse treatment programs.

Written for substance abuse treatment administrators, managers, and supervisors, TAP 31 suggests practical and efficient approaches for introducing and implementing EBPs. It includes steps for assessing an organization’s readiness to adopt new practices, identifying priorities in adopting EBPs, evaluating progress, and sustaining change over time. TAP 31 complements the best practices described in SAMHSA's Center for Substance Abuse Treatment's (CSAT's) Treatment Improvement Protocols.

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Influence of green tea on erythrocytes antioxidant status of different age rats intoxicated with ethanol

Phytotherapy Research Early View 23 Sep 2009

The aim of this paper is to evaluate the effect of green tea on the erythrocyte antioxidant system of ethanol-intoxicated rats, as well as its efficacy in the prevention of lipid peroxidation.

It was shown that ageing was accompanied by changes in the antioxidant enzymes activity - increase in the SOD and CAT activity and decrease in GSSG-R and GSH-Px activity, as well as in the level of non-enzymatic antioxidants - GSH, vitamin A and vitamin E. The increase in the level of lipid peroxidation marker - MDA - was also observed. Green tea consumption partially prevented lipid peroxidation process, especially in erythrocytes of 2- and 12-month-old rats.

It was proved that ethanol administration caused a statistically significant decrease in the activity/level of the examined antioxidants in all age groups (the most significant in the case of 24-month-old rats) of rats, as well as an increase in the MDA level. However, ingestion of green tea by ethanol-intoxicated rats partially prevented the decrease in activity/level of all examined antioxidant parameters, as well as protected lipids against peroxidation in all age groups of rats.

Obtained results confirm the beneficial effect of green tea on erythrocyte antioxidant abilities. Copyright © 2009 John Wiley & Sons, Ltd.

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Alcohol use disorders – clinical management : guideline consultation

A clinical practice guideline on Alcohol use disorders – clinical management is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website.

Consultation dates: 17 September 2009 – 12 November 2009

Consultation documents:
Full guideline
Full guideline appendices
NICE guideline
Comments proforma

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Financing Health Care Reform
A Plan to Ensure the Cost of Reform Is Budget-Neutral

David M. Cutler and Judy Feder

pg. 3 Additional revenue

A third option is sin taxes. Taxes on cigarettes, alcohol, and sugar-sweetened beverages reduce consumption of these products, thus contributing to the overall health of the American people, and raise significant revenue—an estimated $200 billion over the next decade.

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Policy Brief on American Indian and Alaska Native Alcohol Policies

Alcohol remains one of the most pressing public health concerns in many American Indian and Alaska Native communities. As sovereign nations, American Indian and Alaska Native tribes have the ability to pass a wide range of laws to control alcohol, which may be an important component of more comprehensive prevention planning. This policy brief, produced by the Substance Abuse Policy Research Program (SAPRP), focuses on evidence about the potential impact of these policies.

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Early Release of Selected Estimates Based on Data From the January-March 2009 National Health Interview Survey

9. Alcohol consumption

Figure 9.1. Percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year: United States, 1997-March 2009

Figure 9.2. Percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year, by age group and sex: United States, January-March 2009

Figure 9.3. Age-sex-adjusted percentage of adults aged 18 years and over who had five or more drinks in 1 day at least once in the past year, by race/ethnicity: United States, January-March 2009

Data tables for Figures 9.1-9.3

PDF Version

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New Poll Shows Broad Bi‐Partisan Support for Improving Access to Alcohol and Drug Addiction Treatment

September 23, 2009 – A new survey released today shows that in a time of partisan debate over health reform, Americans across party lines agree on improving access to addiction treatment. Despite difficult economic times, most are willing to pay out of their own pocket to make lcohol and drug addiction treatment more accessible and affordable for those who need services. Large majorities see treatment as an effective, ongoing process. Yet many Americans who have personal experience with addiction report that finding affordable treatment is difficult.

Key findings include:

• More than three‐quarters of Americans (77%) support including addiction treatment in health reform, including majorities of Democrats (88%), independents (72%), and Republicans (72%).

• Nearly seven in ten (69%) support paying two dollars more per month in health insurance premiums to make addiction treatment more accessible and affordable, including majorities of support across political parties.

• Only one in four Americans (26%) say there are enough affordable, accessible, quality treatment centers and services in their community; nearly half (47%) reports an inadequate number of treatment centers.

• Of those who know someone who has looked for addiction treatment, 46% say it was difficult finding affordable, quality treatment services. Additionally, a poll conducted in June 20091 found that half (49%) of Americans say they feel they could not afford the costs of treatment if they or someone in their family needed it.

• An awareness gap exists around insurance coverage for treatment. While nearly three‐ uarters (73%) think health insurance plans should cover treatment for addiction, nearly two‐thirds (64%) of insured Americans are not sure whether their plan currently covers treatment services.

Eighty‐eight percent of Americans say treatment is extremely or very important to helping people get better, including 92% of Democrats, 85% of independents and 87% of Republicans.

• Eight in ten Americans (82%) believe that, like diabetes, addiction is a health condition that requires ongoing attention and support. Further, 76% of the public agrees that while it is possible for someone addicted to drugs or alcohol to stop using on their own, long‐term success is unlikely without treatment and ongoing support.

• Americans (87%) see treatment as an ongoing process, sometimes needing more than one period of treatment. Only eight percent say treatment tends to be a onetime occurrence. Additionally, the public sees treatment as effective, even if individuals relapse and need another period of treatment.

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Relation of Alcohol Consumption and Coronary Heart Disease in Hypertensive Male Physicians (from the Physicians' Health Study)

Amer J of Cardiololgy Volume 104, Issue 7, Pages 932-935 (1 October 2009)

Alcohol has diverse effects on the cardiovascular system. Moderate drinking is associated with a decreased risk of cardiovascular disease, yet increasing amounts of alcohol consumption are known to increase blood pressure. These opposing effects have led to interest in the effect of moderate alcohol consumption on the risk of coronary heart disease (CHD) in patients with hypertension.

To test the hypothesis that moderate alcohol consumption decreases the risk of myocardial infarction (MI) in patients with hypertension, we used data on 5,164 participants in the Physicians' Health Study who were apparently healthy and free of CHD at baseline. Incident MI was ascertained by annual follow-up questionnaires and validated through review of medical records.

In conclusion, our data demonstrated an inverse relation between moderate alcohol consumption and CHD in hypertensive men.

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Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood

General Hospital Psychiatry Volume 31, Issue 5, September-October 2009, Pages 442-450

This study examined concurrent and prospective relations between clinical depression, obesity and alcohol use disorders during young adulthood to better understand common etiology and the progression of co-occurrence.

Results show that depression, obesity and alcohol use disorders are interrelated conditions for women. A greater understanding of reasons underlying the co-occurrence of these conditions would benefit prevention and intervention efforts.

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Request Reprint E-Mail: cmccarty@u.washington.edu

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Evidence for the effectiveness and cost–effectiveness of interventions to reduce alcohol-related harm

The WHO European Region has the highest proportion of total ill health and premature death caused by alcohol in the world. The effectiveness of alcohol policies in reducing this harm has been evaluated mainly in North America and northern Europe, but the general principles are applicable across societies and countries.

The evidence summarized in this publication can therefore be applied by policy-makers in every country in the Region to tackle alcohol-related harm. It reviews what is known and not known about the health, social and economic impact of alcohol, education and information campaigns, public support for alcohol policies, supportive infrastructures, the health sector response, community action, workplace policies, drink–driving policies, the availability, marketing and pricing of alcohol, and drinking environments, and the policy implications of this evidence.

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Progress Report on the Implementation of the EU Alcohol Strategy

The first EU Alcohol Strategy was adopted by the European Commission in October 2006 in response to the growing recognition of the health impact of harmful and hazardous alcohol consumption in the EU. The Strategy was endorsed by the other EU institutions indicating that a broad consensus has been achieved in the EU on the approach to tackle alcohol related harm. This is the first report to review progress against strategy implementation.

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HINARI Access to Research Initiative

The HINARI Programme, set up by WHO together with major publishers, enables developing countries to gain access to one of the world's largest collections of biomedical and health literature. Over 6400 journal titles are now available to health institutions in 108 countries, areas and territories benefiting many thousands of health workers and researchers, and in turn, contributing to improved world health.

HINARI Website

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Long-term risk preference and suboptimal decision making following adolescent alcohol use

PNAS published online before print September 21, 2009

Individuals who abused alcohol at an early age show decision-making impairments. However, the question of whether maladaptive choice constitutes a predisposing factor to, or a consequence resulting from, alcohol exposure remains open.

To examine whether a causal link exists between voluntary alcohol consumption during adolescence and adult decision making the present studies used a rodent model.

These findings provide evidence that adolescent alcohol exposure may lead to altered decision making during adulthood and this model offers a promising approach to the investigation of the neurobiological underpinnings of this link.

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Request Reprint E-Mail: ileneb@u.washington.edu

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Positive Serum Ethanol Level and Mortality in Moderate to Severe Traumatic Brain Injury

Arch Surg. 2009;144(9):865-871.

Hypothesis Ethanol exposure is associated with decreased mortality in patients with moderate to severe traumatic brain injury.

A total of 38 019 patients with severe traumatic brain injuries were evaluated. Thirty-eight percent tested positive for ethanol. Ethanol-positive patients were younger (mean [SD], 37.7 [15.1] vs 44.1 [22.0] years, had a lower Injury Severity Score (22.3 [10.0] vs 23.0 [10.3], and a lower Glasgow Coma Scale score (10.0 [5.1] vs 11.0 [4.9], compared with their ethanol-negative counterparts. After logistic regression analysis, ethanol was associated with reduced mortality and higher complications .

Serum ethanol is independently associated with decreased mortality in patients with moderate to severe head injuries. Additional research is warranted to investigate the potential therapeutic implications of this association.

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Request Reprint E-Mail: ali.salim@cshs.org

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Scotland's SNP reveal stark figures on alcohol-related deaths

Figures announced by the Scottish National Party (SNP) show that of the 73 Scottish Parliament constituencies, 64 have alcohol related death rates above the UK average. The figures have prompted a number of media reports such as this one from the Telegraph, headed 'Alcohol kills up to six times more Scots than UK average'. . . . . .

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EPIDEMIOLOGICAL STUDY ON PREVALENCE OF ALCOHOL CONSUMPTION, ALCOHOL DRINKING PATTERNS AND ALCOHOL RELATED HARMS IN MONGOLIA

The “EPIDEMIOLOGICAL STUDY ON PREVALENCE OF ALCOHOL CONSUMPTION, ALCOHOL DRINKING PATTERNS AND ALCOHOL RELATED HARMS IN MONGOLIA survey was undertaken to determine the prevalence of alcohol consumption, alcohol drinking patterns and alcohol related harms among the population.

Survey objectives
1. To determine the prevalence of alcohol consumption
2. To identify the alcohol drinking patterns
3. To determine the prevalence of alcohol dependence
4. To identify health alcohol related harms
5. To identify social alcohol related harms

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Acute Effects of Low Doses of Red Wine on Cardiac Conduction and Repolarization in Young Healthy Subjects

Alcoholism: Clinical and Experimental Research Early View 17 Sep 2009

Moderate to high blood concentrations of ethanol have been shown to yield acute changes in cardiac electrophysiological properties, but the effect of low concentrations have never been assessed. The role of concomitant changes in clinical variables or cardiac dimensions is also still unknown.

This study aimed at exploring the acute effects of low doses of ethanol, administered as Italian red wine, on conduction, depolarization, and repolarization electrocardiographic (ECG) intervals in a population of healthy subjects.

Low doses of red wine acutely slow cardiac conduction and prolong repolarization in normal individuals. These changes are poorly predictable. The potential arrhythmogenic impact of these effects is worthy of exploration.

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Request Reprint E-Mail: pcballo@tin.it

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The Interaction of Reward Genes With Environmental Factors in Contribution to Alcoholism in Mexican Americans

Alcoholism: Clinical and Experimental Research Early View 17 Sep 2009

Alcoholism is a polygenic disorder resulting from reward deficiency; polymorphisms in reward genes including serotonin transporter (5-HTT)-linked polymorphic region (5-HTTLPR), A118G in opioid receptor mu1 (OPRM1), and −141C Insertion/Deletion (Ins/Del) in dopamine receptor D2 (DRD2) as well as environmental factors (education and marital status) might affect the risk of alcoholism.

Objective of the current study was to examine the main and interacting effect of these 3 polymorphisms and 2 environmental factors in contribution to alcoholism in Mexican Americans.

Main effect of education, OPRM1, and DRD2 was detected in alcoholic stratum of moderate and/or largest MAXDRINKS with education ≤12 years, OPRM1 118 A/A, and DRD2 −141C Ins/Ins being risk factors. Classification tree analysis, GMDR analysis, and PIA 2 program all supported education*OPRM1 interaction in alcoholics of largest MAXDRINKS with education ≤12 years coupled with OPRM1 A/A being a high risk factor; dendrogram showed synergistic interaction between these 2 factors; dosage-effect response was also observed for education*OPRM1 interaction. No definite effect of marital status and 5-HTTLPR in pathogenesis of alcoholism was observed.

Our results suggest main effect of education background, OPRM1 A118G, and DRD2 −141C Ins/Del as well as education*OPRM1 interaction in contribution to moderate and/or severe alcoholism in Mexican Americans. Functional relevance of these findings still needs to be explored.

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Request Reprint E-Mail: ywan@kumc.edu

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Evidence for an Interaction Between Age at First Drink and Genetic Influences on DSM-IV Alcohol Dependence Symptoms

Alcoholism: Clinical and Experimental Research Early View 17 Sep 2009

Research suggests that individuals who start drinking at an early age are more likely to subsequently develop alcohol dependence. Twin studies have demonstrated that the liability to age at first drink and to alcohol dependence are influenced by common genetic and environmental factors, however, age at first drink may also environmentally mediate increased risk for alcohol dependence.

In this study, we examine whether age at first drink moderates genetic and environmental influences, via gene × environment interactions, on DSM-IV alcohol dependence symptoms.

Risk for alcohol dependence symptoms increased with decreasing age at first drink. Heritable influences on alcohol dependence symptoms were considerably larger in those who reported an age at first drink prior to 13 years of age. In those with later onset of alcohol use, variance in alcohol dependence was largely attributable to nonshared environmental variance (and measurement error). This evidence for unmeasured gene × measured environment interaction persisted even when controlling for the genetic influences that overlapped between age at first drink and alcohol dependence symptoms.

Early age at first drink may facilitate the expression of genes associated with vulnerability to alcohol dependence symptoms. This is important to consider, not only from a public health standpoint, but also in future genomic studies of alcohol dependence.

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Request Reprint E-Mail: arpana@wustl.edu

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Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia

Addiction Volume 104 Issue 10, Pages 1646 - 1655

To evaluate cost-effectiveness of eight interventions for reducing alcohol-attributable harm and determine the optimal intervention mix.

Although current alcohol intervention in Australia (random breath testing) is cost-effective, if the current spending of $71 million could be invested in a more cost-effective combination of interventions, more than 10 times the amount of health gain could be achieved. Taken as a package of interventions, all seven preventive interventions would be a cost-effective investment that could lead to substantial improvement in population health; only residential treatment is not cost-effective.

Based on current evidence, interventions to reduce harm from alcohol are highly recommended. The potential reduction in costs of treating alcohol-related diseases and injuries mean that substantial improvements in population health can be achieved at a relatively low cost to the health sector.

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Request Reprint E-Mail: l.cobiac@uq.edu.au

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Alcohol and Russian mortality: a continuing crisis

Addiction Volume 104 Issue 10, Pages 1630 - 1636

Russia remains in the grip of a mortality crisis in which alcohol plays a central role. In 2007, male life expectancy at birth was 61 years, while for females it was 74 years. Alcohol is implicated particularly in deaths among working-age men.

There is convincing evidence that alcohol plays an important role in explaining high mortality in Russia, in particular among working age men. However, there remain important uncertainties about the precise scale of the problem and about the health effects of the distinctive pattern of alcohol consumption that is prevalent in Russia today. While there is a need for further research, enough is known to justify the development of a comprehensive inter-sectoral alcohol control strategy. The recent fall in life expectancy in Russia should give a renewed urgency to attempts to move the policy agenda forward.

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Request Reprint E-Mail: david.leon@lshtm.ac.uk

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Driving After Binge Drinking

American Journal of Preventive MedicineVolume 37, Issue 4, October 2009, Pages 314-320

Although binge drinking is strongly associated with alcohol-impaired driving, little is known about the prevalence of or risk factors for driving after binge drinking.

Because binge drinking and subsequent driving were common in establishments licensed to sell alcohol, and because licensing is conditional on responsible beverage service practices (i.e., not selling to intoxicated people), efforts to prevent impaired driving should focus on enforcing responsible beverage service in licensed establishments.

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Request Reprint E-Mail: tnaimi@post.harvard.edu

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Relationship Between Alcohol Use and Violent Behavior Among Urban African American Youths From Adolescence to Emerging Adulthood: A Longitudinal Study

AJPH First Look, published online ahead of print Sep 17, 2009

We examined developmental trajectories of alcohol use and violent behavior among urban African American youths and the longitudinal relationship between these behaviors from adolescence to emerging adulthood.

Violent behavior peaked in middle to late adolescence and declined thereafter, whereas the frequency of alcohol use increased steadily over time. These developmental trajectories varied according to gender. Among both male and female participants, early violent behavior predicted later alcohol use, and early alcohol use predicted later violent behavior. Moreover, changes in one behavior were associated with changes in the other.

Our results support a bidirectional relationship between alcohol use and violent behavior. Efforts to reduce one problem can be expected to reduce the other. Programs and policies aimed at reducing violence or alcohol use among adolescents should take into account this relationship.

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Request Reprint E-Mail: yxue@mathematica-mpr.com
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