Intravenous Ethanol Increases Extracellular Dopamine in the Medial Prefrontal Cortex of the Long–Evans Rat

Ethanol (EtOH) affects prefrontal cortex functional roles such as decision making, working memory, and behavioral control. Yet, the pharmacological effect of EtOH on dopamine, a neuromodulator in the medial prefrontal cortex (mPFC), is unclear. Past studies exploring this topic produced conflicting outcomes; however, a handful of factors (temporal resolution, method of drug administration, estrous cycle) possibly contributed to these discrepancies. We sought to mitigate these factors in order to elucidate EtOH's pharmacological effects on mPFC dopamine in Long–Evans rats.

We administered experimental solutions via an intravenous (iv), handling-free route, monitored dopamine in the mPFC via microdialysis (10-minute samples), and used male rats to avoid estrous cycle/EtOH interactions. First, we rapidly (approximately 2.7 ml/min) or slowly (approximately 0.6 ml/min) administered 1.0 g/kg EtOH and saline infusions, showing that the experimental methods did not contribute to dopamine changes. Then, a cumulative dosing protocol was used to administer 0.25, 0.75, 1.50, and 2.25 g/kg iv EtOH doses to evaluate dose–response. Finally, we monitored dialysate EtOH levels during an oral EtOH self-administration session to compare the dialysate EtOH levels achieved during the pharmacological experiments to those seen during self-administration.

IV administration of a rapid or slow 1.0 g/kg EtOH infusion resulted in similar significant 55 ± 9 and 63 ± 15% peak dialysate dopamine increases, respectively. The 0.25, 0.75, 1.50, and 2.25 g/kg EtOH doses produced a nonsignificant 17 ± 5% and significant 36 ± 15, 68 ± 19, and 86 ± 20% peak dialysate dopamine increases, respectively. Self-administration dialysate EtOH concentrations fell within the range of concentrations noted during the EtOH dose–response curve.

These experiments show that, using experimental methods that minimize possibly confounding factors, acute iv EtOH increases extracellular dopamine in the mPFC in a dose-dependent manner, thereby clarifying EtOH's pharmacological effects on the mesocortical dopamine system.


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

Nicotinic Acetylcholine Receptors are Sensors for Ethanol in Lung Fibroblasts

Chronic ethanol (EtOH) abuse in humans is known to independently increase the incidence of and mortality due to acute lung injury in at-risk individuals. However, the mechanisms by which EtOH affects lung cells remain incompletely elucidated. In earlier work, we reported that EtOH increased the expression in lung fibroblasts of fibronectin, a matrix glycoprotein implicated in lung injury and repair. This effect was blocked by α-bungarotoxin, a neurotoxin that binds certain nicotinic acetylcholine receptors (nAChRs) thereby implicating nAChRs in this process. Here, we examine the identity of these receptors.

Mouse lung fibroblasts were stimulated with EtOH (60 mM) or acetylcholine (100 to 500 μM) and evaluated for the expression of fibronectin and nAChRs. Inhibitors to nAChRs or the antioxidant N-acetyl cysteine (NAC) were used to assess changes in fibronectin expression. Animals exposed to EtOH for up to 6 weeks were used to evaluate the expression of nAChRs in vivo

First, in EtOH-treated fibroblasts, we observed increased expression of α4 and α9 nAChR subunits. Second, we found that acetylcholine, a natural ligand for nAChRs, mimicked the effects of EtOH. Dihydro-β-erythroidin hydrobromide, a competitive inhibitor of α4 nAChR, blocked the increase in fibronectin expression and cell proliferation. Furthermore, EtOH-induced fibronectin expression was inhibited in cells silenced for α4 nAChR. However, EtOH-treated cells showed increased α-bungarotoxin binding suggesting that α4 nAChR mediates the effects of EtOH via a ligand-independent pathway. Knowing there are several important cysteine residues near the ligand-binding site of α4 nAChRs, we tested the antioxidant NAC and found that it too blocked the induction of fibronectin expression by EtOH. Also, fibroblasts exposed to oxidant stress showed increased fibronectin expression that was blocked with α-bungarotoxin. Finally, we showed increased expression of α4 nAChRs in the lung tissue of mice and rats exposed to EtOH suggesting a role for these receptors in vivo

Altogether, our observations suggest that α4 nAChRs serve as sensors for EtOH-induced oxidant stress in lung fibroblasts, thereby revealing a new mechanism by which EtOH may affect lung cells and tissue remodeling and pointing to nAChRs as potential targets for intervention.


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Request Reprint E-Mail:  j.roman@louisville.edu

Molecular Tolerance of Voltage-Gated Calcium Channels is Evident After Short Exposures to Alcohol in Vasopressin-Releasing Nerve Terminals

Voltage-gated calcium channels (VGCCs) in rat neurohypophysial terminals exhibit molecular tolerance to alcohol, including desensitization to the drug and increased current density, after 3 weeks of alcohol drinking. Moreover, after this time, terminals from drinking rats exhibit diminished alcohol inhibition of vasopressin (AVP) release.

We took advantage of organotypic cultures (explants) of the hypothalamo-neurohypophysial system (HNS) to extend our analysis of molecular tolerance to 2 classes of the VGCC. The isolated HNS explant allows much finer temporal resolution of molecular tolerance than do voluntary drinking paradigms. After exposure of the HNS explant to alcohol, terminals are isolated by mechanical treatment and plated in a dish. Patch clamp recording techniques are used to obtain VGCC currents, and immunohistochemistry is used to determine VGCC distribution. A release assay is used to provide functional readout of AVP release.

We show that even a brief, 1-hour exposure to a clinically relevant concentration of alcohol is sufficient to evoke similar changes to those observed after several weeks of exposure. Acute ethanol (EtOH) exposure inhibits high K⁺-induced AVP release from naïve terminals. However, terminals pre-exposed to 20 mM EtOH for 1 hour become tolerant to EtOH, and subsequent exposure has significantly less effect on high K⁺-induced AVP release. Electrophysiological recordings indicate that among different types of VGCCs present in the neuronal terminal, the L-type is the most affected by alcohol. The current density of L-type current is significantly increased (approximately 50%), while its responsiveness to alcohol is significantly diminished (approximately 50%), after brief alcohol exposure. Fluorescent imaging results were consistent with the electrophysiology and suggest that the increased current density of VGCCs after brief exposure is attributable to combined synthesis of 1.2 and 1.3 subtypes of the L-type VGCC and redistribution of channel protein into terminal plasma membrane.

These data indicate that a brief alcohol exposure affects subsequent alcohol sensitivity of VGCCs and neuropeptide release from presynaptic terminals.


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Request Reprint E-Mail:   steven.treistman@upr.edu

The Effects of Chronic Cigarette Smoking on Cognitive Recovery During Early Abstinence from Alcohol

Alcohol use disorders are related to neurocognitive abnormalities during early abstinence in those seeking treatment for alcohol dependence (ALC). Considerable evidence indicates that chronic cigarette smoking is associated with multiple neurocognitive deficiencies. However, very little is known about the effects of chronic smoking on neurocognitive recovery during early abstinence from alcohol. We evaluated whether cigarette smoking interferes with cognitive improvement during early abstinence from alcohol, a period thought important for maintaining long-term sobriety.

Neurocognitive functions previously shown to be adversely affected by both alcohol use disorders and chronic cigarette smoking were evaluated. We assessed 35 smoking ALC (sALC) and 34 nonsmoking ALC (nsALC) at approximately 1 and 5 weeks of monitored abstinence.

Although neither group was clinically impaired, both cross-sectional and longitudinal deficiencies were observed in sALC versus nsALC in processing speed, working memory, and auditory-verbal learning and memory. Lifetime alcohol consumption, medical, and psychiatric comorbidities did not predict neurocognitive performance or improvement across assessments. Within sALC, greater drinking and smoking severities were synergistically (more than additively) related to less improvement on visuospatial learning and memory. Former smoking status in the nsALC-mediated group differences in auditory-verbal delayed recall.

Chronic cigarette smoking appears to negatively impact neurocognition during early abstinence from alcohol. Although the cognitive deficiencies observed in this cohort were not in a clinical range of impairment, they should be considered to enhance treatment efficacy. Our findings lend support to integrating smoking cessation as well as the individual assessment of cognition into early ALC treatment. Additionally, there is a need to elucidate the effects of current and former smoking status in future reports of neurocognition.


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Request Reprint E-Mail:    david.pennington@ucsf.edu

One More Beer? Serving Alcohol to Pseudo-Intoxicated Guests in Bars

Consuming large quantities of alcohol might result in negative consequences for both individual drinkers (alcohol dependency and addiction) and society (violence, traffic crashes). In order to decrease the prevalence of alcohol abuse, many countries have adopted regulations prohibiting the catering industry to serve alcohol to intoxicated guests. This article investigated compliance with these regulations in the Netherlands.

A study was conducted in which pseudo-intoxicated actors tried to order alcoholic drinks in 58 bars. A 2 × 2 design was used, based on (i) the number of actors involved (1 vs. 2) and (ii) the level of intoxication (moderately vs. very drunk). In contrast to earlier studies, research accomplices checked afterward whether the bartenders noticed that the actors appeared intoxicated.

In 86% of the cases, the actors were able to buy alcohol, without comments or questions. In 10%, the actors were refused entrance by a bouncer. Only in 4%, the bartender refused to serve. In 81% of the cases, the bartenders remembered the actors: In 93% of those cases, they noticed that the actor appeared intoxicated. Only the “very drunk” script involving 2 actors led to refusals

The results show that compliance with the regulations regarding overserving to intoxicated guests is problematic in the Netherlands. Misinterpretations of the situation could be ruled out: Most bartenders noticed that the actors appeared intoxicated but served nonetheless.


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Learn More About Preventing Underage Drinking

Nearly 10 million 12- to 20-year-olds in the United States are underage drinkers. These underage drinkers can generate serious negative consequences for individuals, families, and communities. To address underage drinking, it is crucial to understand the nature and extent of the problem, details from recent research, and evidence-based strategies.

The Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) is developing a series of webinars called Preventing Underage Drinking. The current webinar, titled "Introduction and Series Overview," is the first in the series and is available for online viewing. Also, the next webinar in the series will take place on March 7, 2013. Registration will be available soon.

Join more than 2,400 participants in exploring the issues surrounding underage drinking.

 

Watch the First Webinar | Visit the Webinar Series Website

South Africa: Conflict over ban on alcohol advertising

A fierce discussion on possible restrictions on alcohol advertising is currently going on in South Africa. The 53rd ANC National Conference re-confirmed the ANC’s intention to introduce a ban on alcohol adverts.  > > > >  Read More

Is it time for global alcohol consumption guidelines?

A comparison of drinking guidelines around the world shows there is little consensus between countries on what constitutes ‘safe’ or lower risk alcohol consumption. In this guest post,Dr Richard de Visser, a Senior Lecturer in Psychology at the University of Sussex explores the study conducted with Doctoral student Ms Nina Furtwængler. It was published this month in Drug and Alcohol Review.

The study examined government alcohol consumption guidelines in 57 countries, including all 27 European Member States, and found a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis or weekly basis.  > > > >   Read More

Pulmonary inflammation after ethanol exposure and burn injury is attenuated in the absence of IL-6

Alcohol consumption leads to an exaggerated inflammatory response after burn injury. Elevated levels of interleukin-6 (IL-6) in patients are associated with increased morbidity and mortality after injury, and high systemic and pulmonary levels of IL-6 have been observed after the combined insult of ethanol exposure and burn injury. 

To further investigate the role of IL-6 in the pulmonary inflammatory response, we examined leukocyte infiltration and cytokine and chemokine production in the lungs of wild-type and IL-6 knockout mice given vehicle or ethanol (1.11 g/kg) and subjected to a sham or 15% total body surface area burn injury. Levels of neutrophil infiltration and neutrophil chemoattractants were increased to a similar extent in wild-type and IL-6 knockout mice 24 h after burn injury. 

When ethanol exposure preceded the burn injury, however, a further increase of these inflammatory markers was seen only in the wild-type mice. 

Additionally, signal transducer and activator of transcription-3 (STAT3) phosphorylation did not increase in response to ethanol exposure in the IL-6 knockout mice, in contrast to their wild-type counterparts. Visual and imaging analysis of alveolar wall thickness supported these findings and similar results were obtained by blocking IL-6 with antibody. 

Taken together, our data suggest a causal relationship between IL-6 and the excessive pulmonary inflammation observed after the combined insult of ethanol and burn injury.


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Request Reprint E-Mail:    ekovacs@lumc.edu

Use of naltrexone for alcohol use disorders in the Veterans’ Health Administration: A national study

This study aimed to determine the proportion of patients with alcohol use disorders who were prescribed naltrexone in Veterans Administration (VA) Healthcare system for fiscal year (FY) 2010 and socio-demographic and clinical factors associated with its use.

VA national administrative data were used to identify all veterans who had an alcohol use disorder diagnosis (ICD-9-CM codes 303.9x or305.0x) in fiscal year (FY 2010) and were not prescribed any opioids (n = 224,319). Patients in this group who filled a naltrexone prescription during this period were identified. Bivariate analysis was used to evaluate differences between veterans who received naltrexone prescription and those who did not on baseline characteristics and diagnoses. Multivariate logistic regression analysis identified measures that were independently related to receipt of naltrexone.

6172 (2.75%) of the 224,319 patients with a diagnosis of alcohol use disorder who did not receive a prescription for opioid medications received naltrexone prescription. Bivariate analyses showed that patients taking naltrexone were 69 times more likely to have a co-morbid axis I diagnosis. Multivariate logistic regression analysis showed that a history of any substance abuse outpatient visit, any psychiatric outpatient visit or any mental health inpatient hospitalization, were significantly related to filling a prescription for naltrexone.

The rate of use of naltrexone by clinicians and patients remains low and having a co-morbid axis I diagnosis and receiving specialty mental health care were strong predictors of receiving a naltrexone prescription. Understanding the reasons for these findings may further naltrexone's clinical usefulness.




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Request Reprint E-Mail:    theddeus.iheanacho@yale.edu

The effect of drinking goals at treatment entry on longitudinal alcohol use patterns among adults with alcohol dependence

Drinking goals at treatment entry are a promising, yet under-studied mechanism of change in alcohol use following treatment. It is not known who, upon treatment entry, is likely to desire abstinence as a drinking goal and whether desiring abstinence as a drinking goal influences alcohol use following treatment.

Data from a 2.5-year longitudinal study of alcohol-dependent adults from 3 treatment sites is examined in a secondary data analysis. At treatment entry, participants reported sociodemographic and clinical characteristics, as well as whether they desired abstinence as a drinking goal or not. At each subsequent wave, participants reported their alcohol use.

Bivariate analyses showed that individuals from a VA outpatient treatment site, men, and racial or ethnic minorities were most likely to desire abstinence as a drinking goal at treatment entry. Multi-level mixed effects regression models indicated that individuals who at baseline desired abstinence as a drinking goal sustained higher percentage of days abstinent and higher percentage of days since last drink 2.5 years following treatment entry, compared to individuals who did not desire abstinence.

Understanding who is most likely to desire the specific drinking goal of abstinence can assist clinicians in anticipating client response to goal setting. Furthermore, by understanding the benefits and risks associated with drinking goals, clinicians can focus attention to individuals who desire a more risk-laden goal, including goals of non-abstinence, and tailor interventions, including motivational interviewing techniques, to support effective goals.

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Request Reprint E-Mail: omowbray@umich.edu  

Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru

Alcohol use is an important but understudied HIV risk factor among men who have sex with men (MSM), particularly in Latin America. We studied the relationship between problem drinking and sexual risk among MSM in Lima, Peru.

We recruited 718 participants from 24 neighborhoods for a study on sexually transmitted infections and community-building among MSM. Multivariate analysis was used to identify factors independently associated with problem drinking, which was defined via the CAGE Questionnaire.

Of 718 participants, 58% met criteria for problem drinking. In univariate analysis, problem drinkers were significantly more likely to report failing to always use condoms, use alcohol or drugs prior to their most recent sexual encounter, report a history of sexual coercion and to engage in transactional sex. Problem drinkers also reported significantly higher numbers of recent and lifetime sexual partners. In multivariate analysis, factors independently associated with problem drinking included a history of sexual coercion [OR 1.8 95%, CI 1.2–2.6], having consumed alcohol prior to the most recent sexual encounter [OR 2.1 95%, CI 1.5–2.9], receiving compensation for sex in the last six months [OR 1.6, 95% CI 1.1–2.2] or having reported a prior HIV+ test [OR 0.5, 95% CI 0.2–0.9].

We found a high prevalence of problem drinking among MSM in Lima, Peru, which was associated with increased sexual risk in our study. Of note, individuals who were already HIV-infected were less likely to be problem drinkers. Further studies and targeted interventions to reduce problem drinking among MSM are warranted.

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Request Reprint E-Mail:    rdeiss@dhs.lacounty.gov

Age, period, and cohort effects in heavy episodic drinking in the US from 1985 to 2009 ☆

Evaluating population-level patterns of heavy episodic drinking by age, period, and cohort is critical to understanding population-level influences on rates over time and to forecasting future trends for public health planning efforts. The present study examined trends in heavy episodic drinking in the US from 1985 through 2009 in a nationally representative sample that included adolescents and adults.

Data are drawn from repeated cross-sectional surveys of US households as part of the National Household Survey on Drug Use and Health conducted in 1985, 1988, and annually from 1990 though 2009, inclusive (N = 809,281). Heavy episodic drinking was defined as any instance of consuming five or more drinks in one sitting in the past month. Age–period–cohort models were identified using the Intrinsic Estimator algorithm.

Heavy episodic drinking is decreasing in the US among adolescents and young adults, with the most recently born cohorts (born in the 1990s) at lower odds of heavy episodic drinking compared with cohorts born in the 1960s, 1970s, and 1980s. Results were consistent across sex and race/ethnicity, with the exception that the decrease is not apparent among Hispanics.

These data are promising in that young cohorts appear to be reducing heavy episodic drinking, however the lack of decrease among Hispanics suggests targeted intervention and prevention as well as increased surveillance are necessary.

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Request Reprint E-Mail:    kmk2104@columbia.edu

Scottish Borders Alcohol Profile 2013

The Scottish Borders Alcohol Profile 2013 has been produced by the Local Licensing Forum for consideration by the Scottish Borders Licensing Board. It provides data related to the five licensing objectives to inform and strengthen local licensing policy in line with the policy review due by November 2013 and allow informed decision making. The Profile provides details on alcohol consumption, availability, alcohol related antisocial behaviour police incidents, alcohol related attendances at the Emergency Department at Border General Hospital, and children and young people.

Under the Licensing Act, Police, Health and Local Authority have a duty to provide statistical information to support the development of licensing policy.  Alcohol statistics are available both nationally and locally relating to the five
licensing objectives.

This report seeks to provide Scottish Borders Licensing Board with data related to the five licensing objectives to inform and strengthen local licensing policy in line with the policy review and allow informed decision making.

Although we are beginning to see improvements, Scotland still has a high level of alcohol-related harm compared to the rest of the UK and Western and Central Europe. Therefore using Scotland as a bench mark for Scottish Borders is not a challenging comparator. The Scottish Health Survey 2011
shows that within Scottish Borders:

􀂃 43% of adults drink out with the recommended government limits

􀂃 23% of adults drink to hazardous or harmful levels.


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Self-reported alcohol abuse in HIV-HCV co-infected patients: a better predictor of HIV virological rebound than physician's perceptions (HEPAVIH ANRS CO13 cohort)

Studying alcohol abuse impact, as measured by physicians’ perceptions and patients’ self-reports, on HIV virological rebound among patients chronically co-infected with HIV and hepatitis C virus (HCV).

Cohort study.

Seventeen French hospitals.

512 patients receiving antiretroviral therapy (ART) with an undetectable initial HIV viral load and at least two viral load measures during follow-up.

Medical records and self-administered questionnaires. HIV virological rebound defined as HIV viral load above the limit of detection of the given hospital's laboratory test. Alcohol abuse defined as reporting to have drunk regularly at least 4 (for men) or 3 (for women) alcohol units per day during the previous six months. Correlates of time to HIV virological rebound identified using Cox proportional hazards models.

At enrollment, nine percent of patients reported alcohol abuse. Physicians considered 14.8% of all participants as alcohol abusers. Self-reported alcohol abuse was independently associated with HIV virological rebound (hazard ratio [95% confidence interval]: 2.04 [1.13-3.67]; p=0.02), after adjustment for CD4 count, time since ART initiation and hospital HIV caseload. No significant relationship was observed between physician-reported alcohol abuse and virological rebound (p=0.87).

In France, the assessment of alcohol abuse in patients co-infected with HIV and hepatitis C virus should be based on patients’ self-reports, rather than physicians’ perceptions. Baseline screening of self-reported alcohol abuse may help identify co-infected patients at risk of subsequent HIV virological rebound.


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Request Reprint E-Mail:    fabienne.marcellin@inserm.fr

Reducing Heavy Drinking in HIV Primary Care: A Randomized Trial of Brief Intervention, with and without Technological Enhancement

In HIV-infected individuals, heavy drinking compromises survival. In HIV primary care, the efficacy of brief motivational interviewing (MI) to reduce drinking is unknown, alcohol-dependent patients may need greater intervention, and resources are limited. Using Interactive Voice Response (IVR) technology, HealthCall was designed to enhance MI via daily patient self-monitoring calls to an automated telephone  system with personalized feedback. We tested the efficacy of MI-only and MI+HealthCall for drinking reduction among HIV primary care patients.

Parallel random assignment to control (N=88), MI-only (N=82), or MI+HealthCall (N=88). Counselors provided advice-education (control) or MI (MI-only or MI+HealthCall) at baseline. At 30 and 60 days (end-of-treatment), counselors briefly discussed drinking with patients, using HealthCall graphs with MI+HealthCall patients.

Large urban HIV primary care clinic.

Patients consuming ≥4 drinks at least once in prior 30 days.

Using TimeLine FollowBack, primary outcome was number of drinks per drinking day, last 30 days.

End-of-treatment number of drinks per drinking day (NumDD) means were 4.75, 3.94, and 3.58 in control, MI-only and MI+HealthCall, respectively (overall model X²,df=9.11,2, p=.01). For contrasts of NumDD, p=.01 for MI+HealthCall vs. control; p=.07 for MI-only vs. control; and p=.24 for MI+HealthCall vs. MI-only. Secondary analysis indicated no intervention effects on NumDD among non-alcohol dependent patients. However, for contrasts of NumDD among alcohol dependent patients, p<.01 for MI+HealthCall vs. control; p=.09 for MI-only vs. control; and p=.03 for MI+HealthCall vs. MI-only. By 12-month follow-up, although NumDD remained lower among alcohol-dependent patients in MI+HealthCall than others, effects were no longer significant.

For alcohol-dependent HIV patients, enhancing MI with HealthCall may offer additional benefit, without extensive additional staff involvement.


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Request Reprint E-Mail:   dsh2@columbia.edu

Characterizing the Longitudinal Patterns of Substance Use Among Individuals Diagnosed with Serious Mental Illness after Psychiatric Hospitalization

Characterize longitudinal patterns of substance use across a large sample of psychiatric patients discharged from inpatient admission, followed for 1-year post-hospitalization.

Prospective cohort study.

Kansas City, Missouri, USA; Pittsburgh, Pennsylvania, USA; Worcester, Massachusetts, USA.

Eight hundred one schizophrenia-spectrum (N=204), bipolar (N=137) and depressive disorder (N=460) patients from the MacArthur Violence Risk Assessment Study.

Symptoms, functioning, drug/alcohol use assessed by the Brief Psychiatric Rating Scale, the Global Assessment of Functioning, and substance use interviews.

Patients used alcohol (67.0%; N=540) and cannabis (30.0%; N= 237) more frequently than other substances up to 30 days before admission, and those with depressive and schizophrenia-spectrum used heroin more than individuals with bipolar (p =.023). Post-hospitalization, patients using alcohol (B = -.15, p <.001) and cannabis (B= -.27, p <.001) decreased, but patterns varied across diagnosis and genders. Patients using cannabis decreased at greater rates in depressive and schizophrenia-spectrum compared with bipolar (all p <.05), and more men used alcohol (B =.76, p <.001) and cannabis (B = 1.56, p <.001) than women. Cannabis (B = 1.65, p <.001) and alcohol (B = 1.04, p =.002) were associated with higher symptomatology; cannabis (B = -2.33, p <.001) and alcohol (B = -1.45, p =.012) were associated with lower functioning.

Substance use is frequent and associated with poor recovery in patients with serious mental illness recently discharged from psychiatric hospitalization. Addiction treatments personalized by diagnosis and gender may be effective for improving outcomes in people with serious mental illness.


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Request Reprint E-Mail:   alb186@pitt.edu

Diet across the Lifespan and the Association with Breast Density in Adulthood

Studies have shown inconsistent results regarding the association between dietary factors across the lifespan and breast density and breast cancer in women. Breast density is a strong risk factor for breast cancer, and the mechanism through which it influences cancer risk remains unclear. Breast density has been shown to be modifiable, potentially through dietary modifications. 

The goal of this paper is to summarize the current studies on diet and diet-related factors across all ages, determine which dietary factors show the strongest association with breast density, the most critical age of exposure, and identify future directions. 

We identified 28 studies, many of which are cross-sectional, and found that the strongest associations are among vitamin D, calcium, dietary fat, and alcohol in premenopausal women. 

Longitudinal studies with repeated dietary measures as well as the examination of overall diet over time are needed to confirm these findings.


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Alcohol News - 8/2013

GAPA - APPEAL TO GLOBAL HEALTH COMMUNITY

On October 8, 2012, thirteen of world’s largest alcohol producers issued a set of commitments to reduce the harmful use of alcohol worldwide. The commitments were issued in support of the World Health Organization’s (WHO) Global Strategy to Reduce the Harmful Use of Alcohol.

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Prague Apartments (Denmark) - Thousands Of Danish Youngsters Get Drunk And Destroy Apartments In Prague

Hot topic in Czech! Media talk about young Danish students coming to Prague because of cheap alcohol and accommodation. Up to 10 000 of young Danes have already visited Prague this winter. However the goal of their stay is not usually a sightseeing but partying, clubbing or simply buying bottles of alcohol that is much cheaper in Czech Republic than in Denmark.

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YLE.fi (Finland) - Brewers claim 'unprecedented' fall in Finnish alcohol sales

Sales figures from the Federation of the Brewing and Soft Drinks Industry show a 7.4 percent fall in consumption of beers, ciders and other mid-strength alcoholic beverages last year. Soft drink sales fell by 4.4 percent.

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ERR News (Estonia/Finland) - 65% of Finnish Personal Imports of Booze Come from Estonia

Finns transported 7.7 million liters of alcohol to Finland from foreign countries in 2012 and 65 percent of the intoxicating liquid originated from Estonia or from the ferries connecting the two countries.

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BNN News (Latvia) - Latvia prefers cheaper and stronger alcohol

Last year’s excise tax revenue for alcoholic drinks, except beer, increased by 2.85 million LVL, compared to that of 2011, according to the data from the State Revenue Service (SRS).

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The Conversation (Australia) - Social acceptance of alcohol allows us to ignore its harms

Most of us forget that alcohol is a drug so when asked to name drug-related problems, we tend to think of illegal drugs such as cannabis or heroin. But most of us drink, and drinking is an accompaniment to a growing array of activities.

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Radio Australia (Australia) - Judge calls for action on alcohol violence 'epidemic”

NSW's top magistrate calls for action to combat an "epidemic" of alcohol-fuelled violence. New South Wales's most senior magistrate has warned that alcohol-fuelled violence has reached "epidemic proportions" and the community is "fed up" with the perpetrators.

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CarAdvice (Australia) - Victoria to enforce alcohol interlocks for all drink drivers: report

The Herald Sun reports the Victorian State Government has begun drafting new legislation that would require all drivers caught over the legal blood-alcohol limit to have interlock devices fitted to their car to deter them from reoffending.

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Washington Times (Egypt) - Egypt moves to ban alcohol sales

Egypt’s Islamic government will no longer be issuing alcohol permits and will not renew existing ones in certain areas of Cairo, Alexandria and other major cities, an official has said.

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RT (Russia) - Alcohol production in Russia drops 30% in a year

An increase in tax is being blamed for the drop in alcohol production in Russia. According to Rosstat production of spirits has dropped by some 30% in the last year, and some manufacturers have cut production by as much as 80%.

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Almonitor (Egypt) - Turkey's Creeping Alcohol Ban Reaches New Heights

The neo-Islamist Justice and Development Party (AKP) that has ruled Turkey for more than 10 years, parallel to boosting its strength and effectiveness, has for a while also been pursuing a multi-phase campaign to exclude alcohol consumption from public life and make it invisible.

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Irish Examiner (Ireland) - FF: Govt not tackling cheap alcohol issue

In its pre-budget submission, the party asked the Minister for Finance Michael Noonan to include a 10% levy on alcohol sales in off-licences.

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Foodprocessing (Australia) - AMA calls for tighter alcohol regulation

The alcohol industry’s self-regulation has failed, the Australian Medical Association (AMA) has said, with the industry involved pushing to “lure young people into early and potentially harmful drinking patterns”. The AMA is calling on the federal government to launch an inquiry into alcohol marketing to teenagers and young people.

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Irish Independent (Ireland) - Alcohol firms treat teens like beer mats, says bishop

TEENAGERS are being used as "beer mats" by giant drinks firms through their sponsorship of GAA, rugby and soccer, a bishop has claimed.

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Irish Independent (Ireland) - Bishops call for ban on alcohol sponsorships for all youth events

Bishop Eamon Walsh warned it was now time for Ireland to say "enough is enough" in relation to alcohol addiction and the promotion of alcohol to young people.

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Independent Voter Network (USA) - Big Alcohol Lobbying in California Raises Health and Safety Concerns

Big Alcohol lobbying in California made an impact during the 2011-2012 legislative session. Alcohol Justice, a self proclaimed industry watchdog, released a report of Big Alcohol’s efforts in Sacramento.

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Examiner.com (USA) - Final ‘ObamaCare’ rules closing gaps, improving alcohol treatment access in 2014

According to a February 20 U.S. Department of Health and Human Services (HHS) brief on the Affordable Care Act – slangily called ObamaCare – the nation is poised for the “largest expansion in substance use disorder coverage in a generation.”

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BBC News - Gambling and alcohol addiction linked, report says

Gambling and alcohol addiction share greater similarities than previously realised, a new report claims.

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News-Medical.net - EASL unveils new publication - The burden of liver disease in Europe

Major progress has been made in the past 30 years in the knowledge and management of liver disease, yet approximately 29 million Europeans still suffer from a chronic liver condition.

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Irish Independent (Ireland) - Alcohol is now responsible for 25pc of all drug-related deaths

DRUG-RELATED deaths are continuing to fall with the biggest drop among heroin users. But according to new figures, it was a legal drug – alcohol – that was responsible for a quarter of all the deaths and implicated in almost half of poisonings.

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Rescue of Infralimbic mGluR2 Deficit Restores Control Over Drug-Seeking Behavior in Alcohol Dependence

A key deficit in alcohol dependence is disrupted prefrontal function leading to excessive alcohol seeking, but the molecular events underlying the emergence of addictive responses remain unknown. 

Here we show by convergent transcriptome analysis that the pyramidal neurons of the infralimbic cortex are particularly vulnerable for the long-term effects of chronic intermittent ethanol intoxication. These neurons exhibit a pronounced deficit in metabotropic glutamate receptor subtype 2 (mGluR₂). Also, alcohol-dependent rats do not respond to mGluR_2/3 agonist treatment with reducing extracellular glutamate levels in the nucleus accumbens. 

Together these data imply a loss of autoreceptor feedback control. Alcohol-dependent rats show escalation of ethanol seeking, which was abolished by restoring mGluR₂ expression in the infralimbic cortex via viral-mediated gene transfer. Human anterior cingulate cortex from alcoholic patients shows a significant reduction in mGluR₂ transcripts compared to control subjects, suggesting that mGluR₂ loss in the rodent and human corticoaccumbal neurocircuitry may be a major consequence of alcohol dependence and a key pathophysiological mechanism mediating increased propensity to relapse. Normalization of mGluR₂ function within this brain circuit may be of therapeutic value.



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Request Reprint E-Mail:   rainer.spanagel@zi-mannheim.de

The high harm score of alcohol. Time for drug policy to be revisited?

The aim of this paper is to create awareness of the negative health impact and economic burden and benefits associated to alcohol consumption.

Worldwide about two billion people consume alcohol. Low intake of alcohol has a minor protective cardiovascular effect. On the other hand, even moderate alcohol consumption appears to be weakly, but significantly, associated to a limited number of chronic diseases.

Alcohol causes a considerable economic burden to society due to the high absolute number of alcohol consumers. As such, alcohol abuse is more harmful for public health and society than illicit drug use.

Some 3.7% of alcohol consumers (worldwide 76 million people) have an alcohol use disorder leading to 60–70% of the societal costs related to alcohol. Therefore, policy measures should, in addition to regulatory measures to reduce alcohol use, aim at closing the treatment gap and improving treatment effectiveness of people with an alcohol use disorder.

The key message is that policy-makers unjustifiably focus on the harm of illicit drugs, whereas they underestimate the harm of alcohol use. Policy makers should therefore consider alcohol to be at least as harmful as illicit drugs and invest more in prevention and harm reduction strategies for alcohol abuse and dependence.


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Request Reprint E-Mail:     Jan.van.Amsterdam@rivm.nl 

News Release - Scientists identify molecular events that underlie FASD

Scientists have identified a molecular signaling pathway that plays an important role in the development of fetal alcohol spectrum disorders (FASD). The new research in cells and mice, supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, points to candidate genes for FASD susceptibility and may open new avenues for developing drugs to prevent alcohol damage to the fetal brain. A report of the study is now online in the journal Proceedings of the National Academy of Sciences.  > > > >  Read More

Differential changes in impulsivity and sensation seeking and the escalation of substance use from adolescence to early adulthood

Recent evidence suggests that impulsivity and sensation seeking are not stable risk factors for substance use among adolescents and early adults but rather that they undergo significant developmental maturation and change. Further, developmental trends of both personality facets may vary across individuals.

In the current investigation, we used longitudinal data from ages 15 to 26 on 5,632 individuals drawn from the offspring generation of the National Longitudinal Survey of Youth to examine whether interindividual differences in intraindividual change in impulsivity and sensation seeking predicted the escalation of alcohol, marijuana, and cigarette use in adolescence and early adulthood.

Latent growth curve models revealed significant individual differences in rates of change in both personality and substance use. Age-related changes in personality were positively associated with individual differences in substance-use change.

Individuals who declined more slowly in impulsivity increased in alcohol, marijuana, and cigarette more rapidly, whereas individuals who declined more slowly in sensation seeking increased more rapidly in alcohol use only.

Although risk for substance use across the population may peak during adolescence and early adulthood, this risk may be highest among those who decline more gradually in impulsivity.



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Request Reprint E-Mail:   pdquinn@utexas.edu