Choline Supplementation and DNA Methylation in the Hippocampus and Prefrontal Cortex of Rats Exposed to Alcohol During Development

Some of the most frequent deficits seen in children with fetal alcohol spectrum disorders (FASD) and in animal models of FASD are spatial memory impairments and impaired executive functioning, which are likely related to alcohol-induced alterations of the hippocampus and prefrontal cortex (PFC), respectively. Choline, a nutrient supplement, has been shown in a rat model to ameliorate some of alcohol's teratogenic effects, and this effect may be mediated through choline's effects on DNA methylation.

Alcohol was given by intragastric intubation to rat pups during the neonatal period (postnatal days 2 to 10) (ET group), which is equivalent to the third trimester in humans and a period of heightened vulnerability of the brain to alcohol exposure. Control groups included an intubated control group given the intubation procedure without alcohol (IC) and a nontreated control group (NC). Choline or saline was administered subcutaneously to each subject from postnatal days 2 to 20. On postnatal day 21, the brains of the subjects were removed and assayed for global DNA methylation patterning as measured by chemiluminescence using the cpGlobal assay in both the hippocampal region and PFC.

Alcohol exposure caused hypermethylation in the hippocampus and PFC, which was significantly reduced after choline supplementation. In contrast, control animals showed increases in DNA methylation in both regions after choline supplementation, suggesting that choline supplementation has different effects depending upon the initial state of the brain.

This study is the first to show changes in global DNA methylation of the hippocampal region and PFC after neonatal alcohol exposure. Choline supplementation impacts global DNA methylation in these 2 brain regions in alcohol-exposed and control animals in a differential manner. The current findings suggest that both alcohol and choline have substantial impact on the epigenome in the PFC and hippocampus, and future studies will be needed to describe which gene families are impacted in such a way that function of the nervous system is changed.

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Request Reprint E-Mail: sandra-kelly@sc.edu

Adolescents’ Conformity to Their Peers’ Pro-Alcohol and Anti-Alcohol Norms: The Power of Popularity

Research on adolescent development suggests that peer influence may play a key role in explaining adolescents’ willingness to drink, an important predictor of drinking initiation. However, experiments that thoroughly examine these peer influence effects are scarce. This study experimentally examined whether adolescents adapted their willingness to drink when confronted with the pro-alcohol and anti-alcohol norms of peers in a chat room session and whether these effects were moderated by the social status of peers.

We collected survey data on drinking behavior, social status, and willingness to drink among five hundred thirty-two 14- to 15-year-olds. Of this sample, 74 boys participated in a simulated Internet chat room session in which participants were confronted with preprogrammed pro-alcohol or anti-alcohol norms of “grade-mates” which were in fact preprogrammed e-confederates. Accordingly, we tested whether participants adapted their willingness to drink to the norms of these grade-mates. To test whether adaptations in participants’ willingness to drink would depend on grade-mates’ social status, we manipulated their level of popularity.

The results indicated that adolescents adapted their willingness to drink substantially to the pro-alcohol (i.e., more willing to drink) as well as anti-alcohol (i.e., less willing to drink) norms of these peers. Adolescents were more influenced by high-status than low-status peers. Interestingly, the anti-alcohol norms of the popular peers seemed most influential in that adolescents were less willing to drink when they were confronted with the anti-alcohol norms of popular peers. Additionally, the adolescents internalized these anti-alcohol norms.

This study gives more insight into peer influence processes that encourage or discourage alcohol use. These results could be fundamental for the development of prevention and intervention programs to reduce alcohol use among the adolescents.

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Request Reprint E-Mail: h.teunissen@pwo.ru.nl

Face–Name Association Learning and Brain Structural Substrates in Alcoholism

Associative learning is required for face–name association and is impaired in alcoholism, but the cognitive processes and brain structural components underlying this deficit remain unclear. It is also unknown whether prompting alcoholics to implement a deep level of processing during face–name encoding would enhance performance.

Abstinent alcoholics and controls performed a levels-of-processing face–name learning task. Participants indicated whether the face was that of an honest person (deep encoding) or that of a man (shallow encoding). Retrieval was examined using an associative (face–name) recognition task and a single-item (face or name only) recognition task. Participants also underwent 3T structural MRI.

Compared with controls, alcoholics had poorer associative and single-item learning and performed at similar levels. Level of processing at encoding had little effect on recognition performance but affected reaction time (RT). Correlations with brain volumes were generally modest and based primarily on RT in alcoholics, where the deeper the processing at encoding, the more restricted the correlations with brain volumes. In alcoholics, longer control task RTs correlated modestly with smaller tissue volumes across several anterior to posterior brain regions; shallow encoding correlated with calcarine and striatal volumes; deep encoding correlated with precuneus and parietal volumes; and associative recognition RT correlated with cerebellar volumes. In controls, poorer associative recognition with deep encoding correlated significantly with smaller volumes of frontal and striatal structures.

Despite prompting, alcoholics did not take advantage of encoding memoranda at a deep level to enhance face–name recognition accuracy. Nonetheless, conditions of deeper encoding resulted in faster RTs and more specific relations with regional brain volumes than did shallow encoding. The normal relation between associative recognition and corticostriatal volumes was not present in alcoholics. Rather, their speeded RTs occurred at the expense of accuracy and were related most robustly to cerebellar volumes.

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Request Reprint E-Mail: edie@stanford.edu

Youth Recovery Contexts: The Incremental Effects of 12-Step Attendance and Involvement on Adolescent Outpatient Outcomes

A major barrier to youth recovery is finding suitable sobriety-supportive social contexts. National studies reveal most adolescent addiction treatment programs link youths to community 12-step fellowships to help meet this challenge, but little is known empirically regarding the extent to which adolescents attend and benefit from 12-step meetings or whether they derive additional gains from active involvement in prescribed 12-step activities (e.g., contact with a sponsor and other fellowship members). Greater knowledge in this area would enhance the efficiency of clinical continuing care recommendations.

Adolescent outpatients (N = 127; M age 16.7; 75% male; 87% white) enrolled in a naturalistic study of treatment effectiveness were assessed at intake and 3, 6, and 12 months later using standardized assessments. Mixed-effects models, controlling for static and time-varying confounds, examined the concurrent and lagged effects of 12-step attendance and active involvement on abstinence over time.

The proportion attending 12-step meetings was relatively low across follow-up (24 to 29%), but more frequent attendance was independently associated with greater abstinence in concurrent and, to a lesser extent, lagged models. An 8-item composite measure of 12-step involvement did not enhance outcomes over and above attendance, but separate components did; specifically, greater contact with a 12-step sponsor outside of meetings and more verbal participation during meetings.

The benefits of 12-step participation observed among adult samples extend to adolescent outpatients. Community 12-step fellowships appear to provide a useful sobriety-supportive social context for youths seeking recovery, but evidence-based youth-specific 12-step facilitation strategies are needed to enhance outpatient attendance rates.

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Request Reprint E-Mail: jkelly11@partners.org

Tattoos, Piercings, and Alcohol Consumption

Previous studies have found a link between body tattoos or piercings and risky behavior. However, these studies only examined survey data but not real behavior.

Young men (mean = 20.6 years) and women (mean = 20.2 years) leaving a bar were asked whether they wore tattoos and piercings or not and were requested to breathe into a breathalyzer in order to evaluate their alcohol consumption.

It was found that participants with piercings and/or tattoos as well as combined piercings and tattoos revealed higher levels of alcohol consumption.

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Request Reprint E-Mail: nicolas.gueguen@univ-ubs.fr

Piercings and tattoos could serve as signs of alcohol consumption for educators, parents, and physicians.

The Effectiveness of a Cue-Reminder Intervention to Reduce Adolescents' Alcohol Use in Social Contexts

To examine the use of a cue-reminder to target alcohol use among youth in social contexts.

Two experiments were conducted. First, among 92 late adolescents, we tested if a cue-reminder could be effectively associated with information about empowerment, awareness and monitoring of one's own limits with regard to alcohol use. Second, among 107 young adults, the effect of the cue in a real-life drinking setting was examined.

The first study showed that adolescents in the experimental condition recalled more empowerment information compared with adolescents in the control condition (mean 2.00 ± 0.92 vs mean 1.52 ± 0.96, P = 0.017), indicating the possibility of creating an association between a symbol (cue-reminder) and empowerment information with regard to alcohol use. In the second study, significant interaction effects between general drinking frequency and condition were found in relation to having an alcoholic consumption (β = −0.24; P = 0.027) and to the amount of alcoholic consumptions (β = −0.24; P = 0.035), suggesting that the presence of the cue-reminder in a drinking situation may have an inhibitory effect on alcohol consumption among frequent drinkers.

The cue-reminder seems to have the potential to function as an intervention to reduce excessive alcohol use in social settings.



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Request Reprint E-Mail: m.kleinjan@pwo.ru.nl

Minimum alcohol pricing 'will save more than 1,000 lives each year', says NHS think tank

Plans to introduce minimum alcohol pricing would save more than 1,000 lives each year, a report claimed today.

The Government announced last month that it was planning to set a minimum price of 40p per unit of alcohol for England and Wales.

An article published on bmj.com today said the proposal would have significant impacts on alcohol-related deaths, hospital admissions and consumption. > > > > Read More

Translational behavior-genetic studies of alcohol: are we there yet?

In biomedical research, one key stage of translating basic science knowledge to clinical practice is the reconciliation of phenotypes employed for laboratory animal studies with those important for the clinical condition.

Alcohol dependence (AD) is a prototypic complex genetic trait. There is a long history of behavior genetic studies of AD in both human subjects and various genetic animal models.

This review assesses the state of the art in our understanding of the genetic contributions to AD. In particular, it primarily focuses on the phenotypes studied in mouse genetic animal models, comparing them to the aspects of the human condition they are intended to target.

It identifies several features of AD where genetic animal models have been particularly useful, and tries to identify understudied areas where there is good promise for further genetic animal model work.

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Request Reprint E-Mail: crabbe@ohsu.edu

FAT MASS AND OBESITY-ASSOCIATED (FTO) GENE AND ALCOHOL INTAKE

In a recent issue of Addiction, Sobczyk-Kopciol et al. [1] reported an association between the first intron tagging variant rs9939609 in the obesity-predisposing fat mass and obesity-associated (FTO) gene (OMIM no. 610966) and both alcohol consumption and alcohol dependence. Interestingly, the genotype generally associated with elevated risk of obesity [2], acute coronary syndrome [3], some types of cancer [4], end-stage renal disease [5] or overall mortality [6][in all cases at least partially independently on body mass index (BMI)] was associated with lower ethanol consumption, and was less common in alcohol-dependent individuals compared to healthy controls.

Despite the large number of individuals included (6584), an important limitation of the original study [1] is the lack of the confirmatory study. Even large studies are prone to type I error (false positive), and their results need to be replicated [7,8].

To confirm the results by Sobczyk-Kopciol et al. [1], we analysed self-reported alcohol intake (recorded in a standardized interview) and the first intron tagging single nucleotide polymorphisms (SNPs) (rs17817449 or rs9939609; both occur in almost 100% linkage disequilibrium [9]) in three large independent cohorts. We used the Czech post-MONItoring of trends and determinants in Cardiovascular disease (MONICA) study (2559 individuals, examined twice within 3 years) [9], the Czech part of the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study (6681 individuals) [10], and a study of the self-contained population of 948 Sorbs in Germany [11]. Finally, 201 Czech patients with alcoholic liver cirrhosis were also genotyped. Data were analysed using logistic regression with the additive mode of inheritance and adjustment for age and gender. > > > > Read More

What are the public policy implications of a neurobiological view of addiction?

Neuroscience research has provided a greater understanding of the neurochemical mechanisms underpinning drug use and addiction. Alteration of gene regulation and functioning appears to explain many of the persistent changes in brain structure and function that are observed after chronic substance use. These neurobiological changes may explain why relapse is common, even after years of abstinence [1]. This research also indicates that there are molecular, cellular and other system-level mechanisms common to both drug addiction and other compulsive behaviours, such as gambling, hypersexuality and compulsive over-eating [2–4].

How should these findings affect the way in which we deal with addiction to illicit drugs, tobacco smoking, alcohol consumption and ‘behavioural addictions’? Should we view addiction primarily as a disease, like other physical ailments, and treat it medically? This view, often described as the ‘brain disease’ model of addiction, is promoted strongly by prominent public health researchers, neuroscientists and addiction physicians [5,6]. Advocates believe that it will produce a range of clinical and social benefits that include: reduced stigma towards addicted individuals, increased treatment-seeking and compliance with medical treatment regimens, less reliance on imprisonment and other punitive responses to addictive drug use and greater investment in addiction treatment and research [5,6]. > > > > Read More

Heavy maternal alcohol consumption and cerebral palsy in the offspring

The aim of this study was to investigate the association between heavy maternal alcohol consumption and pre- peri- and postneonatally acquired cerebral palsy (CP).

The records of all mothers with an International Classification of Diseases, revision 9 or 10 (ICD-9/-10) alcohol-related diagnostic code, indicating heavy alcohol consumption, recorded on population-based health, mental health, and drug and alcohol data sets from 1983 to 2007, and their children were identified through the Western Australian Data-linkage System. This ‘exposed’ cohort was frequency matched with mothers without an alcohol-related diagnosis and their offspring (comparison group). Cases of CP were identified through linkage with the Western Australia CP Register. Analyses were undertaken using multivariate logistic regression.

There were 23 573 live births in the exposed group (58.6% non-Aboriginal; 41.4% Aboriginal) and 292 cases of CP. The odds of pre/perinatally acquired CP were elevated for children of non-Aboriginal mothers with an alcohol-related diagnosis recorded during pregnancy (adjusted odds ratio 3.32; 95% confidence interval [CI] 1.30–8.48) and for Aboriginal children when an alcohol-related diagnosis was recorded up to 12 months before the mother’s pregnancy (adjusted odds ratio 2.49; 95% CI 0.99–6.25). Increased odds of postneonatally acquired CP following any alcohol-related diagnosis were found for non-Aboriginal children (adjusted odds ratio 7.92; 95% CI 2.23–28.14).

These results suggest that heavy maternal alcohol consumption is a direct cause of pre/perinatally acquired CP, and an indirect cause of postneonatally acquired CP, in non-Aboriginal children. The lack of an association for Aboriginal children requires further investigation but may be due to under ascertainment of alcohol use disorders during pregnancy and other aetiological pathways.

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Request Reprint E-Mail: colleen.oleary@curtin.edu.au

COMT Val158Met modulates the effect of childhood adverse experiences on the risk of alcohol dependence

Genetic factors and childhood adverse experiences contribute to the vulnerability to alcohol dependence. However, empirical data on the interplay between specific genes and adverse experiences are few. The COMT Val158Met and DRD2/ANKK1 Taq1A genotypes have been suggested to affect both stress sensitivity and the risk for alcohol dependence.

This study tested the hypothesis that genetic variation in COMT Val158Met and DRD2/ANKK1 Taq1A interacts with childhood adverse experiences to predict alcohol dependence.

Male abstinent alcohol-dependent patients (n = 110) and age-matched healthy male controls (n = 99) were genotyped for the COMT Val158Met and the DRD2/ANKK1 Taq1A genotypes. Childhood adverse events were measured using three self-report questionnaires. Alcohol dependence severity, age of onset and duration of alcohol dependence were analyzed as secondary outcome measures. Statistical analysis involved logistic regression analysis and analysis of variance.

Alcohol-dependent patients reported increased childhood adversity. The interaction between childhood adversity and the COMT Val158Met genotype added significantly to the prediction model.

This gene–environment interaction was confirmed in the analysis of the secondary outcome measures, i.e. alcohol dependence severity, age of onset and duration of alcohol dependence.

The DRD2/ANKK1 Taq1A genotype was not related to alcohol dependence, nor did it interact with childhood adversity in predicting alcohol dependence.

This study provides evidence for a gene–environment interaction in alcohol dependence, in which an individual's sensitivity to childhood adverse experience is moderated by the COMT genotype. Exposed carriers of a low-activity Met allele have a higher risk to develop severe alcohol dependence than individuals homozygous for the Val allele.

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Request Reprint E-Mail: a.f.a.schellekens@psy.umcn.nl

Twelve Step Facilitation Therapy

Twelve Step Facilitation Therapy (TSF) is a brief, structured, and manual-driven approach to facilitating early recovery from alcohol abuse, alcoholism, and other drug abuse and addiction problems. TSF is implemented with individual clients over 12 to 15 sessions. The intervention is based on the behavioral, spiritual, and cognitive principles of 12-step fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These principles include acknowledging that willpower alone cannot achieve sustained sobriety, that surrender to the group conscience must replace self-centeredness, and that long-term recovery consists of a process of spiritual renewal. Therapy focuses on two general goals: (1) acceptance of the need for abstinence from alcohol and other drug use and (2) surrender, or the willingness to participate actively in 12-step fellowships as a means of sustaining sobriety. The TSF counselor assesses the client's alcohol or drug use, advocates abstinence, explains the basic 12-step concepts, and actively supports and facilitates initial involvement and ongoing participation in AA. The counselor also discusses specific readings from the AA/NA literature with the client, aids the client in using AA/NA resources in crisis times, and presents more advanced concepts such as moral inventories.

The Twelve Step Facilitation manual reviewed for this summary incorporates material originally developed for Project MATCH, an 8-year, national clinical trial of alcoholism treatment matching funded by the National Institute on Alcohol Abuse and Alcoholism. Project MATCH included two independent but parallel matching study arms, one with clients recruited from outpatient settings, the other with patients receiving aftercare treatment following inpatient care. Patients were randomly assigned to Twelve Step Facilitation, Cognitive-Behavioral Therapy, or Motivational Enhancement Therapy. Findings from Project MATCH are included in this summary.

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Press Release - Leading alcohol beverage producers agree to extend common marketing standards and reinforce self-regulation across the EU

Leading producers from the beer, wine and spirits sectors today launched a comprehensive initiative to strengthen independent advertising self-regulatory schemes for alcohol beverage marketing by establishing a set of common, rigorous standards for their marketing communications throughout the European Union.

Under the Responsible Marketing Pact, AB InBev, Bacardi, Brown-Forman, Carlsberg, Diageo, Heineken, Pernod Ricard and SAB Miller, which together represent a majority of European alcohol advertising spend, will work with the World Federation of Advertisers (WFA), EU and national associations to agree and implement common standards for responsible advertising and marketing aimed at adults of legal purchase age, which will be subject to external scrutiny through independent monitoring and public reporting. > > > > Read More

Drinks body tried to alter damning report

A group representing the drinks industry sought to alter paragraphs and remove figures on alcohol-related rape and domestic violence from a special report shaping Government policy.

The Alcohol Beverage Federation of Ireland sought to delete paragraphs and dilute the language in a report on substance misuse created by the National Substance Misuse Steering Group. That group, which sat for almost two years, was tasked with formulating an integrated approach to substance misuse, both alcohol and drugs. Its final report was published in February. > > > > Read More

Liqour sachets banned in Zambia

The Government of Zambia has with immediate effect banned the mafacturing and sale of strong liquor sachets commonly known as tujilijili. This was announced by Minister Luo (picture)at a press briefing in Lusaka on Sunday 15 April, reports The Times of Zambia. > > > > Read More

Alcohol News - 16/2012

MD News (Sweden) - Many Women Still Report Drinking During Pregnancy

Using the Alcohol Use Disorders Identification Test (AUDIT), Erika Comasco, Ph.D., from Uppsala University in Sweden, and colleagues collected data on alcohol consumption before and during pregnancy among 2,264 women from a Swedish antenatal clinic.

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Views and News from Norway (Norway) - Celebrities urged to stop drinking

State health authorities have enlisted the aid of well-known Norwegians to reduce alcohol consumption, by urging them to abstain from any wine, beer or liquor over a two-week period. Among those signing up are skiing star Vibeke Skofterud and the new head of the state police system, Øystein Mæland.

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BBC News (UK) - London Metropolitan University's alcohol-free zone plan

A London university is considering banning the sale of alcohol on parts of its campus. Professor Malcolm Gillies, the vice chancellor of London Metropolitan University, said "cultural sensitivity" was the reason behind the proposal.

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ABC Online (Australia) - Research finds alcohol policy an 'abject failure'

A survey of Darwin's homeless population, the so-called 'long grassers', has found about half drink almost every day and the median weekly quantity for men is nearly 91 drinks.

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The Daily meal - Researchers Discover Carcinogens in Alcoholic Beverages

Passionate wine drinkers are aware of the many substances found in their wines. Things like acids, tannins, and resveratrol float around in every glass. A new study has found that carcinogens can be found in those wines as well.

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Montreal Gazette (Canada) - Quebec’s zero-alcohol law for young drivers comes into effect

Starting Sunday, the “zero alcohol” rule for Quebec drivers age 21 and under comes into force, meaning that young motorists face an immediate three-month suspension of their licence if they’re found to have consumed even a drop of alcohol before getting behind the wheel.

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Marketing Week (EU) - EU-wide alcohol marketing rules planned

AB InBev, Bacardi, Brown-Forman, Carlsberg, Diageo, Heineken, Pernod Ricard and SAB Miller will work with the World Federation of Advertisers (WFA) and national trade associations to establish and implement common standards on social media marketing and age appropriate advertising and scheduling in each of the 27 member states.

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Telegraph.co.uk (UK) - Middle-class children most likely to try alcohol by 12

More than one in three of those born in professional households had downed a full glass before reaching their teenage years, the statistics show.

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Sky News Australia (Australia) - Alcohol 'should carry clear warnings'

Alcohol bottles should carry clear labels warning women of the detrimental effect drinking can have on unborn babies, a parliamentary hearing has been told.

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New York Times (USA) - Indian Beer Bill Stalls; Industry Money Flows

Legislation in Nebraska that would curtail alcohol purchases to residents of a dry Indian reservation has stalled in a key committee whose members have received thousands of dollars in campaign contributions from the alcohol industry, according to state records.

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Adweek (USA) - FTC Broadens Study of Alcohol Advertising

For the first time, the Federal Trade Commission is requiring the major alcoholic beverage advertisers to detail their use of digital marketing and data collection practices.

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WorlDental.org - Excessive Alcohol Consumption Linked to Oral Cancer

Believe it or not, your dentist can actually tell if you have problems with alcohol consumption. The regular dental checkups are recommended twice per year, and these will help maintaining proper oral health. Moreover, regular visits can help with oral cancer early detection and prevention.

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Telegraph.co.uk (EU/UK) - EU law may spike Cameron's alcohol price strategy

High-ranking Treasury officials have admitted that there are questions over the legality of David Cameron's plans for a minimum alcohol unit pricing policy, according to drinks industry sources.

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EurekAlert - Online tool estimates youth exposure to alcohol ads on radio

A new online tool from the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health determines the extent of exposure to radio alcohol advertisements among young people ages 12 to 20 in 75 different media markets. This free and user-friendly tool is the first service to provide parents, health departments and other key audiences with access to customizable information on youth exposure to radio alcohol advertising.

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stv.tv (Scotland) - Alcohol or drugs caused 835 house fires in Scotland

Alcohol or drugs contributed to 835 house fires in Scotland last year, according to statistics. Fire services across the country are urging people to be aware of the increased risks when drinking. Eleven people died and 248 were injured in such incidents last year.

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Easier (UK) - Alcohol and drug interventionists implement new 'McCann Model'

Sober Services Ltd, a private company that specialise in interventions and bespoke addiction recovery services, has announced a new intervention model, known as the 'McCann Model', that is aiding the recovery of addicts and alcoholics and dispelling the myth that addicts must reach a 'rock bottom' before the healing process can begin.

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7thSpace Interactive (WHO) - WHO Western Pacific regional meeting on reducing alcohol-related harm completed

Representatives from the World Health Organization (WHO) and countries in the Western Pacific met in Hong Kong from April 10 to 13 to discuss the prevention and control of non-communicable diseases (NCDs) through reduction of alcohol-related harm.

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Russia Profile (Russia) - The Kremlin Moves to Ban Drinking While Traveling

Russia's love for booze took another hit this week, as the government moved to ban the sale of strong alcoholic beverages on passenger trains.

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Is it merely a myth that alcoholic beverages such as red wine can be cardioprotective?

It has been suggested that although the negative impact of alcohol consumption varies from person to person, on a global level the adverse effect of alcohol on cardiovascular disease outweighs any protective effect by between two- and three-fold. This is inaccurate. There is a proven positive relationship between alcohol consumption and cardiovascular disease that is acknowledged by the World Health Organization.

For example, moderate alcohol consumption reduces the risk of cardiovascular disease by approximately 25%, such that alcohol consumption per se accounts for − 4.7% of the total cardiovascular disease burden in Australia. Correspondingly, cardiovascular disease accounted for 34% of the total number of deaths in Australia in 2008, and 18% of the overall burden of disease in Australia in 2003, with coronary heart disease and stroke contributing over 80% of this burden. Australia is not substantially different from other developed countries having similar demographics to, and the same leading causes of burden as, other high-income developed countries.

This article examines the suggestions and evidence surrounding the relationship between light-to-moderate alcohol consumption and benefits to human health.



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Request Reprint E-Mail: Creina.Stockley@awri.com.au

Epigenetic alteration of the dopamine transporter gene in alcohol-dependent patients is associated with age

Chronic alcohol abuse and dependence are associated with dysfunctional dopaminergic neurotransmission in mesocorticolimbic circuits. Genetic and environmental factors have been shown to modulate susceptibility to alcohol dependence, and both may act through epigenetic mechanisms that can modulate gene expression, e.g. DNA methylation at CpG sites. Recent studies have suggested that DNA methylation patterns may change over time. However, few data are available concerning the rate of these changes in specific genes. A recent study found that hypermethylation of the promoter of the dopamine transporter (DAT) gene was positively correlated with alcohol dependence and negatively correlated with alcohol craving.

The aim of the present study was to replicate these findings in a larger sample of alcohol-dependent patients and population-based controls matched for age and sex.

No difference in methylation level was observed between patients and controls, and no difference in methylation level was observed before and after alcohol withdrawal in patients.

However, patients with more severe craving showed a trend towards lower DAT methylation levels (P = 0.07), which is consistent with previous findings.

Furthermore, in our overall sample, DAT methylation levels increased with age. Interestingly, a separate analysis of patients suggested that this finding was mainly driven by the patient group.

Although the present data do not clarify whether chronic alcohol abuse is responsible for this phenomenon or merely enhances an ageing-specific process, our findings suggest that hypermethylation in alcohol-dependent patients is a consequence, rather than a cause, of the disorder.

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Request Reprint E-Mail: vanessa.nieratschker@zi%E2%80%90mannheim.de

The effect of chronic intermittent ethanol exposure on spatial memory in adolescent rats: The dissociation of metabolic and cognitive tolerances

Using a rapid chronic intermittent ethanol (CIE) vapor exposure paradigm, we demonstrate the dissociability of metabolic tolerance from cognitive tolerance in adolescent rats.

Adolescent rats were trained to spatially navigate in the Morris Water Maze and then exposed to CIE vapor or air 16 h a day for 4 days. After a final 28 h withdrawal, all rats received a saline or ethanol challenge, followed by a test of spatial memory 30 min after administration.

Results indicate that CIE vapor exposure did not significantly impair adolescent spatial memory.

Although CIE-exposed rats developed metabolic tolerance to a subsequent ethanol administration, CIE exposure did not alter dose-dependent ethanol-induced spatial memory impairments.

These data indicate that metabolic ethanol tolerance can be distinguished from cognitive ethanol tolerance during adolescence and suggest that blood alcohol levels alone do not fully explain ethanol-induced spatial memory impairments.


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Request Reprint E-Mail: Candice_Van_Skike@Baylor.edu

Heart rate turbulence during acute alcohol withdrawal syndrome

Alcohol withdrawal syndrome is associated with an increased incidence of cardiac arrhythmias and sudden cardiac death. Heart rate turbulence (HRT) parameters were applied during withdrawal to estimate cardiac regulation during treatment with clomethiazole.

Twenty-two patients suffering from alcohol withdrawal syndrome were included in the study. Heart rate regulation was obtained by means of Holter ECG analyzing time intervals before medication, and 2 and 6h after medication. Slope and onset of HRT were calculated in addition to heart rate variability (HRV) parameters. Furthermore, we calculated the slope and the onset of ectopic beat-like events.

Heart rate variability parameters indicated a minor reduction of vagal modulation during withdrawal syndrome. Especially, the fractal scaling exponent BBI alpha1 (4–16) indicated the autonomic shift. In contrast to HRV parameters, no significant changes were observed in the HRT parameters. Significant correlations were observed between severity of withdrawal, as assessed by the AWS scale, and the fractal scaling exponent BBI alpha2 (16–64), and the onset and the slope of HRT of ectopic beat-like activity.

Increased sympathetic modulation during withdrawal and clomethiazole treatment is not associated with changes of heart rate turbulence parameters predictive of cardiac death after myocardial infarction.

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Request Reprint E-Mail: Karl-Juergen.Baer@med.uni-jena.de

Intensive intervention for alcohol-dependent smokers in early recovery: A randomized trial

The purpose of this study was to investigate the efficacy of an intensive tobacco cessation intervention for alcohol-dependent smokers in early recovery.

A total of 162 alcohol-dependent smokers were randomized to either intensive intervention for smoking cessation or usual care. The intensive intervention consisted of 16 sessions of individual cognitive behavior therapy (CBT) and combination nicotine replacement therapy that lasted 26 weeks. Usual care involved referral to a free-standing smoking cessation program that provided smoking cessation counseling of varying duration and guideline-concordant medications. The primary cessation outcome was verified 7-day point prevalence abstinence (PPA) at 12, 26, 38, and 52 weeks.

At 12 and 26 weeks, the verified 7-day point-prevalence quit rate was significantly higher for the intensive intervention group than for the usual care group (both p=0.03). However, the quit rates for the two treatment groups were not significantly different at 38 or 52 weeks. Verified 30-day alcohol abstinence rates were not significantly different for the two treatment groups at any of the follow-up assessments.

The intensive smoking cessation intervention yielded a higher short-term smoking quit rate without jeopardizing sobriety. A chronic care model might facilitate maintenance of smoking cessation during the first year of alcohol treatment and perhaps for longer periods of time. It is hoped that studies such as this will inform the development of more effective interventions for concurrent alcohol and tobacco use disorders.

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Request Reprint E-Mail: Timothy.Carmody@va.gov

Alcohol's involvement in recurrent child abuse and neglect cases

This paper examined whether: a) caregiver 'alcohol abuse' is associated with recurrent child maltreatment; b) other 'risk factors' affect this relationship; and c) which of alcohol abuse or other drug abuse play a stronger role. It also examined d) how children and families where alcohol-related child abuse was identified were managed by child protection services (CPS) in Victoria, Australia.

Using anonymised data from Victorian CPS, repeat cases involving 29,455 children identified between 2001 and 2005 were examed.

Carer alcohol abuse, other drug abuse, mental ill-health, carer experience of abuse as a child, child age and gender, family type,ocio-economic variables and level of child protection service intervention as recorded in the CPS electronic database were examined as risk factors for recurrence, using bivariate and multivariate techniques.

Findings: Almost one-quarter of children in CPS experienced a recurrent incident of child maltreatment in a five-year period. Where carer alcohol abuse was identified children were significantly more likely to experience multiple incidents compared with children where this was not identified (p<.001), as were children where other family risk factors (including markers of socio-economic disadvantage) were identified. The majority of children whose carers were identified with alcohol abuse experienced either repeat incidents or interventions (84%), although almost three-quarters of these children were managed without resort to the most serious outcome, involving court orders.

Alcohol and drug abuse in carers are important risk-factors for recurrent child maltreatment after accounting for other known risk factors; the increased risk appears to be similar between alcohol and drug abuse.

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Empirical Awakening: The New Science on Mutual Help and Implications for Cost Containment Under Health Care Reform

Over the past 75 years, Alcoholics Anonymous (AA) has grown from 2 members to over 2 million members. AA and similar organizations (e.g., Narcotics Anonymous [NA]) are among the most commonly sought sources of help for substance-related problems in the United States. It is only relatively recently, however, that the scientific community has conducted rigorous studies on the clinical utility and health care cost-offset potential of mutual-help groups and developed and tested professional treatments to facilitate their use.

As a result of this research, AA as an organization has experienced an “empirical awakening,” evolving from its peripheral status as a “nuisance variable” and perceived obstacle to progress to playing a more central role in a scientifically informed recovery oriented system of care.

Also, professionally delivered interventions designed to facilitate the use of AA and NA (“Twelve-Step Facilitation” [TSF]) are now “empirically supported treatments” as defined by US federal agencies and the American Psychological Association.

Under the auspices of health care reform, a rational societal response to the prodigious health and social burden posed by alcohol and other drug misuse should encompass the implementation of empirically based strategies (e.g., TSF) in order to maximize the use of ubiquitous mutual-help recovery resources.



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FASD News - 15/2012

NEWS AND ARTICLES

Kenai Peninsula Online (USA) - FASD receives state, national attention

Fetal Alcohol Spectrum Disorders are gaining widespread attention due to an Alaska Senate Bill and a national act introduced by four United States senators, including Lisa Murkowski and Mark Begich.

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NECN (USA) - Bill letting judges consider FASD passes Senate

A bill that would allow Alaska judges to consider fetal alcohol spectrum disorders during sentencing has unanimously passed the Senate.

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Herald Sun (Australia) - Alcohol ‘should carry clear warnings'

ALCOHOL bottles should carry clear labels warning women of the detrimental effect drinking can have on unborn babies, a parliamentary hearing has been told.

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Asbury Park Press (USA) - Pregnant Pause Baby Fair to Prevent Developmental Disabilities

The Family Resource Network, in partnership with Community Medical Center, will hold its annual Pregnant Pause Baby Fair on Sunday, April 22nd to celebrate healthy pregnancies by educating expecting parents about the importance of an alcohol free pregnancy.

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St. Catharines Standard (Canada) – Should moms who deliver FAS kids be sterilized?

Destroying yourself with alcohol is one thing. Destroying an innocent fetus by excessive use of alcohol is maternal madness. Yet every year alcohol-riddled babies are born in this country suffering from fetal alcohol syndrome (FAS).

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Yukon News - Caring for people with FASD: from joy to pure ‘hell’

“Back in the ‘70s there was nothing on paper to tell you how to take care of a child like this,” said Jenny, who has written a book about her experiences raising a child with FASD.

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Chicago Tribune - Fetal alcohol spectrum disorders

It has been two years since a Tennessee mom sent her 7-year-old adopted son back to Russia with a note that read: "I no longer wish to parent this child." While no definitive diagnosis ever was made public, the boy was thought to suffer from fetal alcohol spectrum disorders.

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Australian Healthcare & Hospitals Association (Australia) - A holistic approach: preventing and managing Foetal Alcohol Spectrum Disorder

A public hearing to explore different aspects of preventing and managing Foetal Alcohol Spectrum Disorder will be held in Sydney this Friday (13 April 2012).

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COMING UP

The University of British Columbia - Fifth National Biennial Conference on Adolescents and Adults with Fetal Alcohol Spectrum Disorder: It's a Matter of Justice

This conference will provide a forum to share research, experience and practice in order to discuss how we can effectively sustain and enhance the lives of adolescents and adults with FASD, their families, service providers, and communities. Are we adequately addressing and supporting the needs and rights of adolescents and adults with FASD within our society?

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MATERIALS

CAMH (Canada) - The Economic Impact of FAS and FASD

The objective of this study was to conduct a systematic review of the literature related to the measurement of the economic impact of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorder (FASD) in different countries and to categorize the available literature.

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RESEARCH

Alcoholism - Delays in Auditory Processing Identified in Preschool Children with FASD

Auditory delay revealed by MEG in children with FASDs may prove to be a useful neural marker of information processing difficulties in young children with prenatal alcohol exposure. The fact that delayed auditory responses were observed across the FASD spectrum suggests that it may be a sensitive measure of alcohol-induced brain damage. Therefore, this measure in conjunction with other clinical tools may prove useful for early identification of alcohol affected children, particularly those without dysmorphia.

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Alcoholism - Selenium or Selenium Plus Folic Acid–Supplemented Diets Ameliorate Renal Oxidation in Ethanol-Exposed Pups

Ethanol (EtOH) exposure during gestation and lactation induces an oxidative stress in offspring. In kidney, the oxidative damage is the primary pathway to alcohol-induced injury. In this study, we have demonstrated that a diet supplemented with selenium (Se) (0.5 ppm) or with Se (0.5 ppm) + folic acid (8 ppm) administered to EtOH-exposed (20% v/v) dams during gestation and lactation prevents the oxidative EtOH-provoked effects in their offspring's kidneys.

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Alcoholism - Alcohol Consumption Among Pregnant Women in a Swedish Sample and Its Effects on the Newborn Outcomes

The sample comprised 2,264 women from a Swedish antenatal clinic. Retrospective self-report data were collected on alcohol consumption before and during pregnancy, using the Alcohol Use Disorders Identification Test (AUDIT), and on nicotine use.

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Alcoholism - Opposing Actions of Ethanol and Nicotine on MicroRNAs are Mediated by Nicotinic Acetylcholine Receptors in Fetal Cerebral Cortical–Derived Neural Progenitor Cells

EtOH and nicotine exert mutually antagonistic, nAChR-mediated effects on teratogen-sensitive miRNAs in fetal NSCs. These data suggest that concurrent exposure to EtOH and nicotine disrupts miRNA regulatory networks that are important for NSC maturation.

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IN OTHER LANGUAGES

Kyffhäuser Nachrichten (Germany) - ALKOHOL IN DER SCHWANGERSCHAFT?

Sie sind lieb, sie sind süß, aber auch distanzlos, zerstörerisch, aggressiv, nicht zu bändigen, locken in uns Mutterinstinkte hervor… und treiben uns manchmal an den Rand der Verzweiflung“. Was soll bloß aus ihnen werden, werden sie jemals erwachsen, d.h. können wir sie allein leben lassen...? Ein Gastbeitrag von Dr. Heike Hoff-Emden...

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Glutamate, GABA, and other cortical metabolite concentrations during early abstinence from alcohol and their associations with neurocognitive changes

Little is known about the effects of alcohol dependence on cortical concentrations of glutamate (Glu) or gamma aminobutyric acid (GABA). We used proton magnetic resonance spectroscopy (MRS) to study cross-sectionally and longitudinally the concentrations of these in alcohol dependent individuals (ALC) during early abstinence from alcohol.

Twenty ALC were studied at about one week of abstinence from alcohol (baseline) and 36 ALC at five weeks of abstinence and compared to 16 light/non-drinking controls (LD). Eleven ALC were studied twice during abstinence. Participants underwent clinical interviewing, blood work, neuropsychological testing, structural imaging and single-volume proton MRS at 4 Tesla. Absolute concentrations of Glu, GABA and those of other ¹H MRS-detectable metabolites were measured in the anterior cingulate (ACC), parieto-occipital cortex (POC) and dorso-lateral prefrontal cortex (DLPFC). Relationships of metabolite levels to drinking severity and neurocognition were also assessed.

ALC at baseline had lower concentrations of Glu, N-acetylaspartate (NAA), choline- (Cho) and creatine-containing metabolites (Cr) than LD in the ACC, but had normal GABA and myo-inositol (mI) levels. At five weeks of abstinence, metabolite concentrations were not significantly different between groups. Between one and five weeks of abstinence, Glu, NAA and Cho levels in the ACC increased significantly. Higher cortical mI concentrations in ALC related to worse neurocognitive outcome.

These MRS data suggest compromised and regionally specific bioenergetics/metabolism in one-week-abstinent ALC that largely normalizes over four weeks of sustained abstinence. The correlation between mI levels and neurocognition affirms the functional relevance of this putative astrocyte marker.

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Improving control over the impulse for reward: Sensitivity of harmful alcohol drinkers to delayed reward but not immediate punishment

Cognitive control dysfunction has been identified in dependent alcohol users and implicated in the transition from abuse to dependence, although evidence of dyscontrol in chronic but non-dependent ‘harmful’ alcohol abusers is mixed.

The current study examined harmful alcohol users response inhibition over rewarding stimuli in the presence of monetary reward and punishment, to determine whether changes in sensitivity to these factors, noted in imaging studies of dependent users, influences impulse control.

Harmful (n = 30) and non-hazardous (n = 55) alcohol users were administered a Monetary Incentive Go/No-go task that required participants to inhibit a prepotent motor response associated with reward.

Harmful alcohol users showed a significantly poorer ability to withhold their impulse for a rewarding stimulus in the presence of immediate monetary punishment for failure, while retaining equivalent response inhibition performance under neutral conditions (associated with neither monetary loss or gain), and significantly better performance under delayed reward conditions.

The results of the present study suggest that non-dependent alcohol abusers have altered sensitivity to reward and punishment that influences their impulse control for reward, in the absence of gross dyscontrol that is consistent with past findings in which such performance contingencies were not used. The ability of delayed monetary reward, but not punishment, to increase sustained impulse control in this sample has implications for the mechanism that might underlie the transition from alcohol abuse to dependence, as well as intervention strategies aimed at preventing this transition.


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