Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

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Tuesday, August 13, 2013

Assessing the Effects of Medical Marijuana Laws on Marijuana and Alcohol Use: The Devil is in the Details


This paper sheds light on previous inconsistencies identified in the literature regarding the relationship between medical marijuana laws (MML) and recreational marijuana use by closely examining the importance of policy dimensions (registration requirements, home cultivation, dispensaries) and the timing of them. Using data from our own legal analysis of state MMLs, we evaluate which features are ass

ociated with adult and youth recreational use by linking these policy variables to data from the National Longitudinal Survey of Youth (NLSY97), the Youth Risk Behavior Survey (YRBS) and the Treatment Episodes Data System (TEDS). Our analyses control for state and year fixed effects, using within state policy changes over time to estimate the effect on changes in our outcome variables using a difference-in-differences approach.

We find that while simple dichotomous indicators are generally not associated with marijuana use, specific dimensions of MMLs, namely home cultivation and legal dispensaries, are positively associated with marijuana use in each data set.
Moreover, these same dimensions are tied to binge drinking and fatal alcohol automobile accidents as well.

The findings have important implications for states considering legalization of marijuana, as regulating access to and promotion of dispensaries may be key for reducing the harms associated with these policies.


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Monday, August 12, 2013

News Release - Alcohol use among pregnant women in substance abuse treatment drops in past decade, but illicit drug use rises



According to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) the percentage of pregnant woman in substance abuse treatment using alcohol (with or without drug use) dropped from 46.6 percent to 34.8 percent over a ten year period. However, the report also shows that the percentage of substance abuse admissions involving pregnant women using drugs (without co-occurring alcohol use) rose from 51.1 percent to 63.8 percent during this same period.
The proportion of women of childbearing age (age 15 to 44) who were pregnant when entering treatment remained relatively stable between 2000 (4.4 percent) and 2010 (4.8 percent). The study also showed that non-pregnant women of childbearing age experienced similar trends in substance use as their pregnant counterparts.   > > > >  Read More
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Alcohol News - 32/2013




 
 
 
 
 



 
UPI.com - Using alcohol to self medicate increases addiction risk
Using alcohol as though it were a medication -- to ease feelings of depression -- are more likely to become alcohol dependent, U.S. researchers say.
News-Medical.net - Higher cigarette tax leads to lower alcohol consumption!
While people may think, that since that one intoxication could be substituted by another – a rise in cigarette taxes could lead to an increase in alcohol consumption. However, a recent study in the US says higher cigarette tax can also lead to less alcohol consumption among smokers.
Daily News & Analysis (India) - Kids as young as 11 getting introduced to alcohol: Rajeshwari Luther
Alcoholism and drug addiction are assuming epidemic proportions and we are not doing enough, said Rajeshwari Luther, director of Hyderabad-based Hope Trust that has been offering treatment for alcoholism and drug addiction for a decade now.
Hurriyet Daily News (Turkey) - Turkish authority introduces ‘Alcohol is not your friend’ tag on bottles
Signs warning about the possible harms of alcohol consumption will be placed on the bottles of alcoholic beverages within 10 months, according to a statement published in the Official Gazette Aug. 11.
Daily Mail (UK) - Over-65 drinkers in health alert: Doctors call for alcohol safety levels to be halved for pensioners
Doctors and public health experts said heavy drinking among the elderly was a ‘hidden problem’ and safe limit guidelines for over-65s should be halved.
BBC News (UK) - North East experts renew minimum alcohol price call
North East England has been "let down" by plans to introduce minimum alcohol pricing being shelved, experts said.
The Japan Times (USA) - Alcohol linked to many deaths of pedestrians
Just as drinking and driving can be deadly, so can drinking and walking. Over a third of U.S. pedestrians killed in 2011 had blood alcohol levels above the legal limit for driving, government data show.
Belfast Telegraph (Northern Ireland) - Doctors hail minimum alcohol price
A minimum price of at least 50p should be set for small amounts of alcohol in Northern Ireland, doctors said. Some drink are sold for less than the cost of water but the health service bill may be as high as £160 million a year, research showed.
Coventry Telegraph (UK) - Barbecue boozing leads to spike in alcohol-related violence in Coventry
Police in Coventry are warning that increased barbecue boozing has led to a spike in alcohol-related violence.
MetroNews Canada (Canada) - Alcohol costs exceed revenues in B.C., study shows
A group of researchers is calling for a sober second look at alcohol policies in B.C. after finding the costs associated with booze far outweigh the revenues it brings in.
Arutz Sheva (Israel) - Recommendation: Raise the Age for Buying Alcohol to 21
A special committee of the Health Ministry has recently formulated a series of new recommendations to reduce excess consumption of alcohol and the resulting drunkedness, violence and auto accidents, according to a Thursday-evening report by Channel 2 Television.
World Bulletin (Turkey) - Turkish state to cover alcohol, drug addiction treatment expenses
The costs of drug and alcohol Addiction treatment will be covered by the state as part of a new joint initiative by the Health Ministry and the Social Security Institution (SGK).
The Border Mail (Australia) - Govt bid to recoup cost of drunken behaviour
People may have to pay for the costs they incur to the state while drunk if an "abuser pays" system recommended by the Auditor-General is adopted by the NSW government.
TVNZ (New Zealand) - Bars want drunks fined, police shun idea
Wellington bar owners are urging the city council to introduce fines for drunks on the streets but police say earlier closing times for bars is the best way to curb alcohol problems.
TimesLive (South Africa) - Booze ad ban is 'on track'
A proposal that alcohol advertising be banned has been approved by an inter-ministerial committee on substance abuse.
The Local (Sweden) - Systembolaget bans beer with grenade logo
Sweden's state controlled alcohol monopoly has ruled out distributing the Welsh export 'Fubar' beer due its label featuring a hand grenade and bullet holes.
TISPOL (Estonia) - Estonian police: zero tolerance for drink-driving
Police in Estonia took severe measures to prevent drink driving during the recent midsummer festivities. Many drink drivers were detained and taken to court. Midsummer Day is one of the biggest national holidays on June 23rd and 24th and sadly it often involves alcohol related problems such as drink driving, road deaths and serious injuries.
Alcohol and Alcoholism - Defining Substance Use Disorders: Do We Really Need More Than Heavy Use?
‘Heavy substance use over time’ seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.
15min.lt (Lithuania) - Former Lithuanian prime minister takes part in discussions on extra stickers on tax stamps
As a consultant for a firm making security labels, Adolfas Šleževičius, a former prime minister of Lithuania, is taking part in discussions at the Finance Ministry about putting additional stickers on cigarette packs and alcoholic drinks as anti-counterfeit protection for tax stamps, the daily Lietuvos Rytas reports.
TIME (Africa) - Africa’s Drinking Problem: Alcoholism on the Rise as Beverage Multinationals Circle
In Kenya, depending on whom you ask, John Mututho is either a hero or a villain, but in a country consuming ever more alcohol, he is certainly a household name. In 2010, Mututho won a battle with the beverage industry to implement Kenya’s first alcohol-control act.
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NIH issues online course on screening youth for alcohol problems


A new online training course will help health care professionals conduct fast, evidence-based alcohol screening and brief intervention with youth. The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, produced the course jointly with Medscape, a leading provider of online continuing medical education.

“Just in time for back-to-school physicals, physicians, physician assistants, and nurses can learn how to use a simple youth alcohol screening tool and earn up to 2.5 continuing education credits or contact hours,” said Kenneth R. Warren, Ph.D., acting director of NIAAA. “This new course joins NIAAA’s family of evidence-based, user-friendly products to help clinicians identify patients of all ages who are at risk for alcohol-related problems, and to intervene early, when we have the best chance to prevent problems.”
 
The course presents three engaging case scenarios of youth at different levels of risk for alcohol-related harm. The scenarios illustrate a streamlined, 4-step clinical process outlined in Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide. NIAAA produced the guide in 2011 in collaboration with the American Academy of Pediatrics (AAP),which recommends screening all adolescents regarding alcohol use.  > > > >  Read More
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'Stick to the facts': Alcohol Concern call for tougher regulation on alcohol advertising

 
Alcohol Concern have called for a major shake up of the alcohol advertising regulation framework to achieve a better balance between public health concerns and commercial freedoms.
The 'Stick to the facts' report says advertising creates social norms around alcohol and promotes the normalisation of drinking in society. Exposure to alcohol marketing is linked to consumption, particularly in the under 18's. In light of the growing body of evidence, Alcohol Concern argue that a sensible policy response is needed and call for a ban on advertising at all sporting, cultural and music events.
Young people involved in YAAC (Youth Alcohol Advertising Council) reported minors are exposed to content which appeals to them, particularly via social media, and how advertisers make associations with prohibited themes despite the current regulations. The report also claims that alcohol advertisers are exploiting weak rules, particularly around digital and internet advertising. > > > >  Read More
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Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption(




To date, 19 states have passed medical marijuana laws, yet very little is known about their effects. The current study examines the relationship between the legalization of medical marijuana and traffic fatalities, the leading cause of death among Americans ages 5–34.

 The first full year after coming into effect, legalization is associated with an 8–11 percent decrease in traffic fatalities. The impact of legalization on traffic fatalities involving alcohol is larger and estimated with more precision than its impact on traffic fatalities that do not involve alcohol.

Legalization is also associated with sharp decreases in the price of marijuana and alcohol consumption, which suggests that marijuana and alcohol are substitutes.

Because alternative mechanisms cannot be ruled out, the negative relationship between legalization and alcohol-related traffic fatalities does not necessarily imply that driving under the influence of marijuana is safer than driving under the influence of alcohol.



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Request Reprint E-Mail:     dwight.anderson@montana.edu
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Ethanol Self-Administration in Serotonin Transporter Knockout Mice: Unconstrained Demand & Elasticity




Low serotonin function is associated with alcoholism, leading to speculation that increasing serotonin function could decrease ethanol consumption. Mice with one or two deletions of the serotonin transporter (SERT) gene have increased extracellular serotonin.
To examine the relationship between SERT genotype and motivation for alcohol, we compared ethanol self-administration in mice with zero (KO), one (HET), or two copies (WT) of the SERT gene. All three genotypes learned to self-administer ethanol.

The SSRI, fluvoxamine, decreased responding for ethanol in the HET and WT, but not the KO mice. When tested under a progressive ratio schedule, KO mice had lower breakpoints than HET or WT. As work requirements were increased across sessions, behavioral economic analysis of ethanol self-administration indicated that the decreased breakpoint in KO as compared to HET or WT mice was a result of lower levels of unconstrained demand, rather than differences in elasticity, i.e., the proportional decreases in ethanol earned with increasing work requirements were similar across genotypes.

The difference in unconstrained demand was unlikely to result from motor or general motivational factors, as both WT and KO mice responded at high levels for a 50% condensed milk solution. As elasticity is hypothesized to measure essential value, these results indicate that KO value ethanol similarly to WT or HET mice despite having lower break points for ethanol.


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Request Reprint E-Mail:    lamb@uthscsa.edu
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Group management of pharmacotherapy for alcohol dependence: Feasibility and impact on adoption




One of the barriers to initiating patients on medications for alcohol dependence is concern about the work involved in providing ongoing medication management. In this brief report, we describe our initial experiences with a medication management group, initially implemented to provide continued access during a staffing shortage.

We describe the group structure and functioning, and provide initial analysis of the groups’ impact on access and adoption of pharmacotherapy for alcohol dependence.
Results of an interrupted time series analysis in one Veterans Health Administration (VHA) facility provide support for the notion that the group format is not only feasible but can actually increase access to these under-utilized medications (e.g., naltrexone and acamprosate).

The number of patients receiving these medications was already increasing in this facility before the switch to group appointments, but this rate of initiation increased almost 3-fold after the onset of the groups.

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Request Reprint E-Mail:   Alexander.Harris2@va.gov
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Characterizing Gender Differences in Treatment Seekers





Available evidence suggests women may be more vulnerable to the effects of chronic alcohol consumption than men. The few investigations of gender differences in treatment-seeking populations have often involved study samples restricted by selection criteria (e.g., age, education). The current study examined gender differences in a heterogeneous sample of individuals seeking treatment for a substance use disorder. We examined alcohol drinking levels, age at drinking milestones (e.g., first drink, first intoxication), and progression from milestones to alcohol problems or treatment. Additionally, family history, spousal alcoholism, and nicotine use were analyzed.
 
Participants included men (n = 274) and women (n = 257) in substance abuse treatment facilities. Participants completed inventories quantifying affect, intellectual ability, and drinking consequences. A family tree for substance use and personal histories for alcohol and nicotine use, including chronicity, frequency, and regularity, were collected.
 
Telescoping was not observed when progression from drinking milestones to alcoholism or alcohol problems was compared between men and women. In contrast, when considered as progression to treatment, marked telescoping effects were detected, with women entering treatment more rapidly by approximately 4 years. Familial differences included a greater proportion of women reporting alcoholic parents (73% women; 61% men) and alcoholic spouses (58% women; 38% men). Smoking behaviors were similar between genders; however, men reporting higher levels of alcohol consumption reported greater intensity of chronic smoking. Smoking and drinking behaviors were correlated among men, but not women. Rates of pretreatment drug problems were equivalent between genders.
 
When contrasted with the available literature, our data were only partially supportive of gender-contingent telescoping. While women did not experience alcohol problems or alcoholism earlier than men, they progressed to treatment more quickly. These results highlight the importance of carefully considering the sample and specific outcome variables when interpreting gender differences.



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Request Reprint E-Mail:     benlewis@ufl.edu
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Increased Cigarette Tax is Associated with Reductions in Alcohol Consumption in a Longitudinal U.S. Sample





Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample.
 
Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group.
 
Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category.
 
Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors.


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Request Reprint E-Mail:     sherry.mckee@yale.edu
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Racial Differences in Type of Alcoholic Beverage Consumed During Adolescence in the Pittsburgh Girls Study




White, compared with Black, adolescents have higher rates of alcohol use and show more rapid increases in alcohol use. Racial differences in type of alcohol beverage (i.e., beer, wine, and liquor) consumed by youth have received scant attention, and little is known regarding changes in type of alcohol beverage consumed during adolescence, when experimentation may transition to more regular use.
 
This study used repeated measures latent class analysis to identify distinct profiles that represent change in type of alcohol beverage consumed across ages 11 to 18 and to examine predictors (e.g., caretaker alcohol use, perceived peer alcohol use, ease in accessing alcohol, perceived neighborhood risk indicated by witnessing drug dealing), most of which were measured at ages 11 to 12, of alcohol use profiles in the Pittsburgh Girls Study (n = 2,171; 57% Black, 43% White), a community sample with annual follow-ups.
 
Among Black girls, 2 profiles were identified: Low Use (76%), and Alcohol Use involving primarily liquor starting around age 15 (24%). Among White girls, 4 profiles were identified: Wine sippers (11%); a Low Use profile with low probability of drinking until age 18, when use of beer and liquor increased (52%); an Increasing Use profile with increased probability of drinking beer and liquor starting at age 15 (23%); and a High Alcohol Use profile, starting with use of wine, then shifting to use primarily of beer and liquor after age 13 (14%). Separate risk factor analyses conducted by race indicated similar predictors for Black and White girls: perceived ease in accessing alcohol, witnessing neighborhood drug dealing, and perceived peer alcohol use were each associated with heavier drinking profiles.
 
Longitudinal profiles of type of alcoholic beverages, within and across racial groups, can guide the tailoring of interventions to address developmentally salient turning points in alcohol use for specific subgroups of girls.



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Request Reprint E-Mail:       chungta@upmc.edu
 
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Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a dose-response meta-analysis of prospective studies




To summarise the evidence regarding the dose-response association between alcohol consumption and risk of rheumatoid arthritis (RA).
 
Studies were identified from search of MEDLINE, Embase and Web of Science databases between 1 January 1946 and 10 April 2013, and from review of the conference abstracts and the reference lists of retrieved articles. Prospective studies that reported relative risks (RRs) with 95% CIs for the association between alcohol consumption and the risk of RA were included. Results from individual studies were pooled using a dose-response meta-analysis.
 
Up to 10 April 2013, 8 prospective studies contained 195 029 participants and 1878 RA cases were included. The results indicated that low to moderate alcohol consumption yielded a preventive effect on RA development (RR: 0.86; 95% CI 0.78 to 0.94), and provided some evidence of a non-linear relationship between alcohol consumption and risk of RA. Dose-response meta-analysis of the study data revealed that compared with that for no alcohol consumption, the adjusted RR was 0.93 (95% CI 0.88 to 0.98) for 3 g/day of alcohol consumption, 0.86 (95% CI 0.76 to 0.97) for 9 g/day, 0.88 (95% CI 0.78 to 0.99) for 12 g/day, 0.91 (95% CI 0.81 to 1.03) for 15 g/day, and 1.28 (95% CI 0.94 to 1.73) for 30 g/day. Subgroup analysis indicated that women who had low to moderate alcohol consumption had a 19% reduction in RA risk. Regardless of sex, a consistent low to moderate alcohol consumption for a period of at least 10 years was found to have a 17% reduction in RA risk.
 
Low to moderate alcohol consumption inversely associated with the development of RA in a manner that appears to be dose-dependent, time-dependent and sex-dependent. Large prospective studies that investigate gene-environment interactions are required to further clarify the aetiology of RA.



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Request Reprint E-Mail:    hejia63@yahoo.com
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Sunday, August 11, 2013

Helping Yourself to Recovery




Helping others has been an integral part of the folk wisdom about addiction recovery for more than 250 years. From early Native American recovery circles, early Euro-American recovery mutual aid societies and the 20th century advent of 12-Step recovery through the ever-widening menu of religious, spiritual and secular recovery pathways, the message has been clear: help yourself by helping others. The helping prescription is based on two core ideas. The first is the concept of wounded healer--the notion that people who have experienced and survived an illness or great trauma may have acquired unique perspectives that allow them to offer assistance to others in similar circumstances. The second is what sociologist Frank Riessman called the helper principle--the idea that the act of helping benefits the helper as much (or quite often more) than the person being helped. > > > >  Read More 
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Does Science Show What 12 Steps Know?



 

Science has never revealed as much about addiction—potential genetic causes, influences, and triggers, and the resultant brain activity—or offered as many opportunities and methods  for initial treatment as it does now.

Even so, the grassroots 12-step program remains the preferred prescription for achieving long-term sobriety.
Since the inception of Alcoholics Anonymous (A.A.)—the progenitor of 12-step programs—science has sometimes been at odds with the notion that laypeople can cure themselves.
Yet the success of the 12-step approach may ultimately be explained through medical science and psychology. Both offer substantive reasons for why it works.  > > > >  Read More
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Saturday, August 10, 2013

Facial Dysmorphism Across the Fetal Alcohol Spectrum




Classic facial characteristics of fetal alcohol syndrome (FAS) are shortened palpebral fissures, smooth philtrum, and thin upper vermillion. We aim to help pediatricians detect facial dysmorphism across the fetal alcohol spectrum, especially among nonsyndromal heavily exposed (HE) individuals without classic facial characteristics.

Of 192 Cape Coloured children recruited, 69 were born to women who reported abstaining from alcohol during pregnancy. According to multifaceted criteria, the remainder were allocated clinically to the FAS (n = 22), partial FAS (n = 26) or nonsyndromal HE (n = 75) categories. We used dense surface modeling and signature analyses of 3-dimensional facial photographs to determine agreement between clinical categorization and classifications induced from face shape alone, to visualize facial differences, and to consider predictive links between face shape and neurobehavior. 
                   
Face classification achieved significant agreement with clinical categories for discrimination of nonexposed from FAS alone (face: 0.97–1.00; profile: 0.92) or with the addition of partial FAS (face: 0.90; profile: 0.92). Visualizations of face signatures delineated dysmorphism across the fetal alcohol spectrum and in half of the nonsyndromal HE category face signature graphs detected facial characteristics consistent with prenatal alcohol exposure. This subgroup performed less well on IQ and learning tests than did nonsyndromal subjects without classic facial characteristics.

Heat maps and morphing visualizations of face signatures may help clinicians detect facial dysmorphism across the fetal alcohol spectrum. Face signature graphs show potential for identifying nonsyndromal heavily exposed children who lack the classic facial phenotype but have cognitive impairment.



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Request Reprint E-Mail:    p.hammond@ucl.ac.uk
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Friday, August 9, 2013

Effects of binge drinking on action cascading processes: an EEG study





High-dosage alcohol intoxication (i.e., binge drinking in humans) is an increasingly prevalent problem. Despite the well-known long-term consequences, the acute effects of high-dosage alcohol intoxication on cognitive control processes have not been investigated with respect to neurophysiological changes in humans.

We provide insights into the effects of high-dosage ethanol intoxication on action control functions in humans on the basis of neurophysiological (EEG) data. Action control processes were examined in a stop–change task.

Based on a detailed analysis of behavioral and electrophysiological data, we demonstrate a specific modulation of action cascading processes. Opposed to commonly held views, high-dosage ethanol intoxication (0.9–1.13 ‰) exerts highly specific effects on cognitive subprocesses mediating action control.

If action control processes are performed in succession, intoxicated and non-intoxicated participants perform equally well. However, action control processes become compromised during high-dosage ethanol intoxication, when different response options require processing resources in parallel.

Under high-dose ethanol intoxication, subjects are not able to prioritize different response options. We could demonstrate that the effects were of high effect sizes (η2 = 0.702) and rely more on response selection deficits than on deficits in attentional processing.

The changes in response selection processes are mediated via the anterior cingulate cortex. The specificity of the observed effects may be due to a differential involvement of dopaminergic and GABAergic processes in action control and attentional selection processes.



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Request Reprint E-Mail:    Ann-Kathrin.Stock@rub.de
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