How We Get Addicted 
Toolkit Supports Efforts in Native Communities to Prevent Fetal Alcohol Spectrum Disorders
SAMHSA's Road to Recovery Update
Summer 2007, Number 13Table of Contents
Six- and Twelve-Month Outcomes among Homeless Youth Accessing Therapy and Case Management Services through an Urban Drop-in CenterTo evaluate the impact of case management and individual therapy offered through a drop-in center for homeless youth on substance use, mental health, housing, education, employment, and medical care utilization.
Statistically significant improvements were found in substance abuse, mental health, and percent days housed up to 12 months postbaseline. Decreased alcohol and drug use was associated with an increase in housing.While treatment offered through drop-in centers for homeless youth can positively impact homeless youth, policy, funding, and service provision need greater focus, collaboration, and support if youth homelessness is to be successfully addressed.
Reprint Request E-Mail: nslesnick@ehe.osu.edu
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Variation in the gene coding for the M5 Muscarinic receptor (CHRM5) influences cigarette dose but is not associated with dependence to drugs of addiction: evidence from a prospective population based cohort study of young adults| The mesolimbic structures of the brain are important in the anticipation and perception of reward. Moreover, many drugs of addiction elicit their response in these structures. The M5 muscarinic receptor (M5R) is expressed in dopamine-containing neurones of the substantia nigra pars compacta and ventral tegmental area, and regulates the release of mesolimbic dopamine. Mice lacking M5R show a substantial reduction in both reward and withdrawal responses to morphine and cocaine. The CHRM5, the gene that codes for the M5R, is a strong biological candidate for a role in human addiction. This is the first study to show an association between CHRM5 and substance use in humans. These data support the further investigation of this gene as a risk factor in substance use and dependence. Read Full Text (PDF) _________________________________________________________________ |
Smoking, alcohol and dietary choices: evidence from the Portuguese National Health Survey Unhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits.
The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population.
This study showed that smokers have a higher intake of alcoholic beverages and a lower consumption of food items rich in fibre, antioxidants, or phytochemicals, which are suspected to have beneficial roles in the prevention of multiple chronic diseases.
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Policing the drunk driver: Measuring law enforcement involvement in reducing alcohol-impaired drivingA formula generating a potentially useful metric for assessing aspects of the DUI prosecutorial chain is presented, focusing on the rate of proactive DUI arrests.
While in need of cautious interpretation due to issues of inherent inaccuracies in large databases, small numbers of crashes and/or arrests in multiple jurisdictions, and the lack of replication in other states, the analyses show no relationship between the level of DUI arrest activity and DUI-related crashes.
This finding brings into question the efficacy of the many millions of dollars devoted each year to targeted DUI enforcement, as it is currently being implemented.
Results are discussed in terms of developing adequate disincentives to DUI so as to raise general deterrence via dramatic increases in proactive DUI enforcement and then engaging in pervasive and persistent social marketing of such efforts to maximize the perception that arrest and punishment for DUI is always imminent, that penalties will be swift, certain, and severe.
Reprint Request E-Mail: dulac@etsu.edu
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Effects of acute alcohol intoxication on visuospatial attention
Marin Institute News for July 4, 2007
Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence
Gender, Early Alcohol Use, and Suicide Ideation and Attempts: Findings from the 2005 Youth Risk Behavior SurveyTo examine the cross-sectional associations between preteen alcohol use initiation and subsequent suicide ideation and attempts for boys and girls in a nationally representative sample of high school students.
Among study participants, 25.4% reported drinking before age 13 years. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and suicide attempts relative to those in nondrinkers. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and attempts relative to nondrinkers for both boys and girls.
Alcohol use among adolescents, particularly preteen alcohol use initiation, is an important risk factor for both suicide ideation and suicide attempts among boys and girls. Increased efforts to delay and reduce early alcohol use are needed, and may reduce suicide attempts.
Reprint Request E-Mail: MSwahn@cdc.gov
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Adolescents’ Attention to Responsibility Messages in Magazine Alcohol Advertisements: An Eye-Tracking ApproachTo investigate whether adolescent readers attend to responsibility or moderation messages (e.g., “drink responsibly”) included in magazine advertisements for alcoholic beverages and to assess the association between attention and the ability to accurately recall the content of these messages.
Overall, the responsibility or moderation messages were the least frequently viewed textual or visual areas of the advertisements. Participants spent an average of only .35 seconds, or 7% of the total viewing time, fixating on each responsibility message. Beverage bottles, product logos, and cartoon illustrations were the most frequently viewed elements of the advertisements.
Among those participants who fixated at least once on an advertisement’s warning message, only a relatively small percentage were able to recall its general concept or restate it verbatim in the masked recall test.
Voluntary responsibility or moderation messages failed to capture the attention of teenagers who participated in this study and need to be typographically modified to be more effective.
Reactions to a Concept for Physician Intervention in Adolescent Alcohol Use This study was designed to understand adolescent and parental perceptions, receptivity, and reactions to the concept of screening and brief intervention that primary care physicians can use to reduce alcohol consumption by their non-alcohol-dependent adolescent patients.
Parents and adolescents held similar views on the prevalence and harms of adolescent alcohol consumption, but different levels of concern about them. After initial surprise and needed dispelling of misconceptions, all groups expressed interest, support, and suggestions for the concept of a physician-initiated, office-based intervention to address younger adolescent alcohol use.
Because both adolescents and parents of adolescents expressed interest in this type of intervention, physicians should be aware of this receptivity and consider focus group findings in how to structure development of a potential counseling-based intervention.
Prior education about the target and nature of the intervention is necessary, lest adolescents and parents assume—incorrectly—that it is about doctors preaching to high-risk adolescents to stop drinking.
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TRIADD: THE RISK FOR ALCOHOL ABUSE, DEPRESSION, AND DIABETES MULTIMORBIDITY IN THE AMERICAN INDIAN AND ALASKA NATIVE POPULATION
Prevalence and patterns of alcohol use in the Australian workforce: findings from the 2001 National Drug Strategy Household SurveyTo describe Australian workers' prevalence and patterns of alcohol use.
Approximately 8% of the workforce drank at least weekly at short-term risky or high risk levels, 17% drank at least monthly, 18% drank at least yearly and 11% drank at long-term risky or high risk levels. The prevalence of risky or high risk drinking was higher for younger than for older workers.Risky and high risk drinking occurred at least occasionally in 44% of Australian workers. Workers in the hospitality, agriculture, manufacturing, construction and retail industries, workers in blue-collar occupations and young workers were identified as at-risk subgroups.
These data provide evidence that patterns of consumption differ between occupational and industry groups, and highlight the pressing need to develop policies, prevention and intervention strategies to reduce harmful alcohol use in Australia, particularly among young adults.
Advancing the analysis of treatment process To review the role of process research in clinical research, to summarize progress in statistical methods for process analyses, and to describe a dynamic analytical approach that can provide new insights into the processes responsible for the effects of treatments and other variables.
Process research helps us to understand what happens during our interventions, and can yield valuable knowledge regardless of whether an intervention is found to have significant effects. This is a review of recent statistical advances for dealing with missing data, tests for mediation and hierarchical modeling and demonstrate how these advances can help process researchers overcome obstacles that had limited past studies. However, the standard paradigm for process analysis, although conceptually sound, is based upon a static model that does little justice to the dynamics of treatment.
Therefore, it is proposed that the paradigm is extended to study the time–course of dynamic processes, using existing statistical methods. Hierarchical linear modeling, structural regression modeling and event history methods are among the most promising tools for more advanced process analyses because of their ability to incorporate time-varying predictors.
The function of process analysis is to probe into the mechanisms of action of treatment to locate both weaknesses and strengths, but methods for process research are still rudimentary. By conceptualizing process analysis as a problem of relating multiple time-series, many new analytical opportunities, and challenges, present themselves.
Modern statistical methods can help to lead to broad advances in our understanding of the processes that affect treatment success.
Reprint Request E-Mail: stout@pire.org
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Addiction sciences and its psychometrics: the measurement of alcohol-related problems The focus of this paper is on psychometric issues related to the measurement of alcohol problems.
Taking a broad perspective, this paper first examines several issues around the use of instruments to provide diagnostic categories in surveys, including dimensionality, severity and alcohol consumption.
Secondly, a discussion of some of the political issues surrounding measurement of alcohol problems is presented, including some of the conflicts that arise when the psychometric properties of commonly used instruments are questioned.
Finally, newer statistical techniques that can be applied to scale development in the alcohol field are examined, including non-linear multivariate analyses and confirmatory/hypothesis-based methods.
Continued scholarly discussion needs to be encouraged around these psychometric issues so that instrument development and maintenance in the addiction sciences becomes an ongoing academic pursuit as we strive to measure alcohol problems in the best way possible.
Rethinking the paradigms that inform behavioral treatment research for substance use disorders Over the last three decades, the randomized controlled trial or ‘psychotherapy technology’ approach has been the dominant model of inquiry in research on addiction treatment. This period has yielded impressive discoveries, but recent failures to confirm core research hypotheses such as occurred in Project MATCH and the Cocaine Collaborative Treatment Study have raised questions about future research directions.
The paper identifies several testable assumptions of the psychotherapy technology model.
A review is conducted on four substance use disorder behavioral interventions—motivational interviewing, cognitive–behavioral treatment, behavioral couples treatment and 12-Step-oriented treatment—to determine whether these assumptions are supported by research findings.
Overall, the review suggests weak support for the technology model of psychotherapy research. Lack of support is interpreted as indicating flaws in several model assumptions about how to conceptualize and measure patient responsivity and the interaction of non-specific and specific therapeutic factors.
The paper offers alternative strategies for addressing these issues drawn from the general psychotherapy process literature and provides illustrative examples of how these could be used to spur innovation in addiction treatment research.
The addiction treatment research field is coming up against the limitations of the psychotherapy technology model as the dominant paradigm guiding treatment research. It is important for addiction treatment researchers to explore alternative conceptualizations and methodologies in order to understand more clearly how treatment works.
Reprint Request E-Mail: jm977@columbia.edu
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Alcohol accounts for a high proportion of premature mortality in central and eastern EuropeThere is a west–east mortality gradient in Europe, more pronounced in men.
The objective of this article was to quantify the contribution of alcohol use to the gap in premature adult mortality between three old (France, Sweden and United Kingdom) and four new (Czech Republic, Hungary, Lithuania and Poland) European Union (EU) member states for the year 2002. Russia was added as an external comparator.
Alcohol consumption was responsible for 14.6% of all premature adult mortality in the eight countries, 17.3% in men and 8.0% in women. This proportion was clearly higher in the new EU member states and Russia compared with the comparison countries from the old EU.
For men, Russia with 29.0 alcohol-attributable premature deaths per 10 000 population had a more than 10-fold higher rate compared with Sweden (2.7 deaths/10 000). For women, the ratio between Hungary (5.0 alcohol-attributable deaths/10 000) and Russia (4.7 deaths/10 000) compared with Sweden (0.5 deaths/10 000) was almost as high, but the rates were much lower.
The Czech Republic and Poland showed proportionally less alcohol-attributable premature mortality than the other new EU member states or Russia for both genders, which, however, was still higher than in any of the old EU member states.
Alcohol is a strong contributor to the health gap between western and central and eastern Europe, with both average volume of consumption and patterns of drinking contributing to burden of disease and injury. Alcohol also contributes substantially to male–female differences in mortality and life expectancy.
However, there are feasible and cost-effective measures to reduce alcohol-related burden that should be implemented in central and eastern Europe.