The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 173-182



This research examines adolescent perceptions of neighborhood disorganization and social capital to determine if they are associated with adolescent alcohol or drug (AOD) use, AOD dependence, and access to AOD treatment.

Neighborhood disorganization was self-reported by youth in response to eight items; 10 items measured social capital. AOD use was also self-reported. AOD dependence was assessed by a series of questions regarding symptoms and impairment that is consistent with the criteria specified in the DSM-IV.

A little more than half of the youth reported never using alcohol or drugs (54.3%), 41.1% reported lifetime AOD use, and 4.6% were AOD dependent. Two percent reported receiving AOD treatment.

Medium and high levels of social capital were negatively associated with AOD use and dependence. Social capital was unrelated to access to AOD treatment.

Neighborhood disorganization was positively associated with AOD use, dependence, and access to treatment After controlling for individual- and family-level characteristics, neighborhood disorganization and social capital were associated with AOD use and dependence.

The findings suggest that subjective measures of social context may be an important component of the complex biopsychosocial model of adolescent AOD addiction and treatment utilization.

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Request Reprint E-Mail: erinwinstanley@mac.com

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Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 239-247


We extend the literature on the association of early onset of drug use and estimated risk for developing a substance use disorder (SUD) by investigating the risk that recent onset of alcohol and cannabis use confers for developing a substance use disorder at each chronological age of adolescence and young adulthood (12–21-years-old).

The results indicated that the teenage years were strongly linked to an elevated risk status.

The odds ratio (OR) of having a prior year alcohol use disorder (AUD) among recent onset alcohol users was significantly elevated for youth at ages 14, 16, 17 and 18 (range of ORs = 2.0–2.1) compared to the estimated risk for AUD among recent onset users aged 22–26.

For cannabis, we obtained significantly elevated ORs for a cannabis use disorder (CUD) at each of teenage years (ages 12–18; range of ORs = 3.9–7.2), when compared to older recent onset users (aged 22–26).

These data provide further epidemiological support that adolescence is a particularly vulnerable period for developing a SUD.

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Request Reprint E-Mail: winte001@umn.edu

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Responsiveness of EQ-5D utility indices in alcohol-dependent patients
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 291-295

The EQ-5D provides community-based preference weights (utilities) for calculating quality adjusted life years (QALYs) in cost-utility analysis.

This study aimed to analyze the responsiveness of EQ-5D-based utilities in patients with alcohol dependence.

ES were rather trivial to medium for all EQ-5D indices (ranging from |0.10| to |0.59|) related to a shift from “same” to “less” problems in the two anchors. Differences in scores of the EQ-5D indices revealing a shift from “same” to “less” problems according to the two anchors were not significant.

These results suggest that the EQ-5D indices are less responsive and require larger patient samples to detect meaningful clinical differences compared to the other used instruments. Additional research is needed to compare societal and clinical views on relevant change in health status in this patient group.

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Request Reprint E-Mail: oliver.guenther@medizin.uni-leipzig.de

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Smaller feedback ERN amplitudes during the BART are associated with a greater family history density of alcohol problems in treatment-naïve alcoholics
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 141-148

Alcoholism is characterized by impaired decision-making (i.e., choosing intoxication in the face of mounting negative consequences). This impairment may involve a reduced brain response to the negative consequences of behavior, which supports an inclination to engage in risky behaviors.

The feedback error-related negativity (F-ERN) is hypothesized to reflect the valence attached to the negative consequences of behavior. Performance on the Balloon Analogue Risk Task (BART) measures risk-taking propensity. We recorded F-ERNs during the BART and during a BART simulation, where individuals observed the rewards and consequences of (someone else's) BART performance.

F-ERNs over fronto-central electrode sites were observed to balloon pops in the BART and BART simulation. F-ERNs during the BART were more than twice the amplitude of F-ERNs during the BART simulation. Smaller F-ERN amplitudes from the BART (but not the BART simulation) were associated with a greater family history density of alcohol problems.

The results suggest a possible link between the genetic vulnerability toward developing alcoholism and the brain's response to the negative consequences of behavior.

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Request Reprint E-Mail: george@nbresearch.com

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The influence of legal coercion on dropout from substance abuse treatment: Results from a national survey
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 123-131


Legal coercion is frequently used to leverage substance abuse treatment upon persons who would otherwise not seek it voluntarily. Various methodological and conceptual problems of the existing research have prevented a clear understanding of its effectiveness.

The influence of legal coercion on retention in substance abuse treatment was examined using a national survey of programs in the public sector of care and three different treatment modalities including short-term residential , long-term residential , and outpatient treatment.

Legal coercion was found to reduce the risk of dropout across all three treatment modalities. The greatest effect was among persons in short-term residential treatment. The smallest effect was observed in outpatient treatment.

This study shows that legal coercion significantly reduces the risk of dropout in substance abuse treatment. However, the differential effects across treatment conditions must be carefully considered when using coercion to involve individuals in treatment.

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Request Reprint E-Mail: beperron@umich.edu
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Problem-free drinking over 16 years among individuals with alcohol use disorders
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 116-122


Limited data exist on the rates and long-term stability of non-problem drinking in individuals who sought help for an alcohol use disorder.

A sample of initially untreated individuals with alcohol use disorders (n = 420) was surveyed at baseline and 1 year and was re-assessed at 8 and 16 years.

In the 6 months prior to the 1-year assessment, 36% (n = 152) of participants reported abstinence from alcohol, 48% (n = 200) reported drinking with problems, and 16% (n = 68) reported non-problem drinking.

At each follow up, 16–21% of the sample reported non-problem drinking. Compared to individuals in the abstinent and problem-drinking groups, individuals who were drinking in a problem-free manner at 1 year had reported, at baseline, fewer days of intoxication, drinks per drinking day, alcohol dependence symptoms, and alcohol-related problems, less depression, and more adaptive coping mechanisms.

Over time, 48% of participants who engaged in non-problem drinking at 1 year continued to report positive outcomes (either non-problem drinking or abstinence) throughout the long-term follow-up, whereas 77% of those abstaining at 1 year reported positive outcomes throughout the same time period.

Additionally, 43% of individuals with problematic alcohol consumption at 1 year reported positive outcomes over the remaining follow-up interval, a rate that was not significantly different from the rate of positive outcomes of 48% observed in those with initial problem-free drinking.

Although some individuals report non-problem drinking a year after initially seeking help, this pattern of alcohol use is relatively infrequent and is less stable over time than is abstinence.

An accurate understanding of the long-term course of alcohol use and problems could help shape expectations about the realistic probability of positive outcomes for individuals considering moderate drinking as a treatment goal.

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Request Reprint E-Mail: mark.ilgen@va.gov

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Ethnic differences in alcohol treatment outcomes and the effect of concurrent smoking cessation treatment
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 61-68

The Timing of Alcohol and Smoking Cessation (TASC) Study tested the optimal timing of smoking cessation treatment in an alcohol-dependent population. Previously reported results suggest that providing concurrent smoking cessation treatment adversely affects alcohol outcomes.

The purpose of this analysis was to investigate whether there are ethnic differences in alcohol and tobacco outcomes among a diverse sample of alcohol-dependent smokers using data from the TASC trial in which 499 participants were randomized to either concurrent (during alcohol treatment) or delayed (6 months later) smoking intervention.

This analysis focused on smokers of Caucasian (n = 381) and African American (n = 78) ethnicity. Alcohol outcomes included 6 months sustained alcohol abstinence rates and time to first use of alcohol post-treatment. Tobacco outcomes included 7-day point prevalence smoking abstinence. Random effects logistic regression analysis was used to investigate intervention group and ethnic differences in the longitudinally assessed alcohol outcomes.

Alcohol abstinence outcomes were consistently worse in the concurrent group than the delayed group among Caucasians, but this was not the case for African Americans. No significant ethnic differences were observed in smoking cessation outcomes.

Findings from this analysis suggest that concurrent smoking cessation treatment adversely affects alcohol outcomes for Caucasians but not necessarily for African Americans.

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Request Reprint E-Mail: Steven.Fu@va.gov
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Prefrontal cortex modulation using transcranial DC stimulation reduces alcohol craving: A double-blind, sham-controlled study
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 55-60


Functional neuroimaging studies have shown that specific brain areas are associated with alcohol craving including the dorsolateral prefrontal cortex (DLPFC). We tested whether modulation of DLPFC using transcranial direct current stimulation (tDCS) could alter alcohol craving in patients with alcohol dependence while being exposed to alcohol cues.

Our results showed that both anodal left/cathodal right and anodal right/cathodal left significantly decreased alcohol craving compared to sham stimulation (p <>

Our findings showed that tDCS treatment to DLPFC can reduce alcohol craving. These findings extend the results of previous studies using noninvasive brain stimulation to reduce craving in humans. Given the relatively rapid suppressive effect of tDCS and the highly fluctuating nature of alcohol craving, this technique may prove to be a valuable treatment strategy within the clinical setting.

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Request Reprint E-Mail: ffregni@bidmc.harvard.edu
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Norepinephrine transporter polymorphisms T-182C and G1287A are not associated with alcohol dependence and its clinical subgroups
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 20-26


Several studies have suggested that the norepinephrine transporter (NET) may play an important role in the pathogenesis of alcohol dependence. Additional studies have shown that the polymorphisms of T-182C (rs2242446) and G1287A (rs5569) in NET gene (hSLC6A2) may affect the NET function.

Therefore, in this study, we examined whether these hSLC6A2 gene polymorphisms are a susceptibility factor for alcohol dependence or its clinical subgroup(s).

No significant differences in genotype and allele frequencies of hSLC6A2 polymorphisms were found between controls and total alcohol dependence or between more homogeneous subgroups with alcohol dependence and controls.

This study suggests that the polymorphisms of T-182C and G1287A in hSLC6A2 gene are not major risk factors in increasing susceptibility to either alcohol dependence or its clinical subtypes.

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Request Reprint E-Mail: hsy@ndmctsgh.edu.tw
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The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): Reliability of new psychiatric diagnostic modules and risk factors in a general population sample
Drug and Alcohol Dependence Volume 92, Issues 1-3, 1 January 2008, Pages 27-36


This study presents test–retest reliability statistics and information on internal consistency for new diagnostic modules and risk factors for alcohol, drug, and psychiatric disorders from the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV).

Test–retest statistics were derived from a random sample of 1899 adults selected from 34,653 respondents who participated in the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face.

Test–retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa > 0.63; ICC > 0.69; alpha > 0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations = 0.50–0.94; alpha = 0.64–0.90).

The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings.

The availability of highly reliable measures of risk factors for alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology.


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Request Reprint E-Mail: bgrant@willco.niaaa.nih.gov
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Modeling the complexity of post-treatment drinking: It's a rocky road to relapse
Clinical Psychology Review Volume 27, Issue 6, July 2007, Pages 724-738



The most widely cited road block to successful treatment outcomes for psychological and substance use disorders has been described as the return to the previous behavior, or “relapse.”

The operational definition of “relapse” varies from study to study and between clinicians, but in general the term is used to indicate the return to previous levels of symptomatic behavior.

One explanation for the variation in the operationalization of relapse is the wide variety of behaviors for which the term is applied, including (but not limited to): depression, substance abuse, schizophrenia, mania, sexual offending, risky sexual behavior, dieting, and the anxiety disorders. A second explanation for the multitude of definitions for relapse is the inherent complexity in the process of behavior change.

In this paper we present the most recent treatment outcome research evaluating relapse rates, with a special focus on the substance use disorders. Following this review of the literature we present an argument for the operationalization of relapse as a dynamic process, which can be empirically characterized using dynamical systems theory.

We support this argument by presenting results from the analysis of alcohol treatment outcomes using catastrophe modeling techniques. These results demonstrate the utility of catastrophe theory in modeling the alcohol relapse process.

The implications of these analyses for the treatment of alcohol use disorders, as well as a discussion of future research incorporating nonlinear dynamical systems theory is provided.

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Request Reprint E-Mail: kate19@u.washington.edu
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Revealed: Brown's secret summit to beat binge drinking



A Downing Street meeting on 'the harm caused by problematic alcohol consumption' drew 27 top doctors, campaigners, business chiefs and ministers. Jonathan Owen and Ian Griggs report

Published: 09 December 2007

The Prime Minister has held crisis talks at No 10 in a personal attempt to tackle Britain's binge-drinking epidemic, as experts warn that urgent action is needed to tackle record numbers needing hospital treatment for alcohol abuse.

Confidential minutes from the meeting, obtained by the IoS, reveal for the first time how Gordon Brown, together with senior ministers, plan a radical response to Britain's binge-drinking problem that could see excessive drinking become as taboo as smoking in public.

A blueprint of controversial measures discussed at the private meeting will see a massive crackdown on what Mr Brown calls "the harm caused by problematic alcohol consumption", with the Prime Minister vowing to take action against "unacceptable drinking behaviour."
. . . . . .

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Jellinek Memorial Fund
Alcohol and Alcoholism 2007 42(5):508



The Board Directors of the Jellinek Memorial Fund is pleased to announce that the 2007 Jellinek Memorial Award for Epidemiology and Populations Studies was awarded to Dr. Bridget F. Grant.

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Trazodone Improves Sleep, but Decreases Abstinence in Recovering Alcoholics

Marlene Busko

December 7, 2007 — Despite short-term benefit in sleep quality, trazodone impeded improvements in alcohol consumption in recovering alcoholics with sleeping problems, in a double-blind placebo-controlled trial by Peter D. Friedman, MD, and colleagues at Alpert Medical School of Brown University, in Providence, Rhode Island.
. . . . . .

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Forum on addictions draws candidate aides

By JASON SCHREIBER
Union Leader Correspondent
Monday, Dec. 3, 2007

PLAISTOW – Matthew Walker is getting the help he needs, but it's costing him.

He's a recovering drug addict who spends $100 a week to receive treatment at a methadone clinic in Newington three days a week.

Walker has been visiting the clinic for about a year and a half.

"We're talking pretty serious money," the 36-year-old New London man said.

When he first began looking into treatment, Walker hoped insurance would cover it. But with the co-payments that were required for each visit, he said, he was better off paying out of his own pocket.

Realizing the financial burdens facing many addicts just like him, Walker turned out at a Presidential Town Hall Meeting yesterday to urge presidential candidates to take a serious look at the many drug, alcohol and mental health issues plaguing New Hampshire and the nation.

Candidates themselves did not attend the statewide meeting, at the Timberlane Regional Performing Arts Center, but representatives from several presidential campaigns listened to recovering drug addicts and alcoholics, their families, friends, law enforcement officers and others.
. . . . .

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December 2nd New Hampshire Presidential Town Hall Meeting

Representatives from nine US Presidential campaigns appeared at the December 2, 2007 Plaistow, NH Presidential Town Hall, where they spoke and responded to questions about candidates’ positions on key addiction prevention, treatment and recovery issues, including ending insurance discrimination.

• See pictures from the event!
• View a flyer about the event
• Read our media advisory about the event
• Read a recent article about the forum

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Moderate alcohol consumption and lipoprotein-associated phospholipase A2 activity
Nutrition, Metabolism and Cardiovascular Diseases Article in Press, 3 Dec 200

To investigate the effect of moderate alcohol consumption on lipoprotein-associated phospholipase A2 activity, markers of inflammation and oxidative stress and whether these effects are modified by BMI.

Eleven lean (BMI: 18.5–25 kg/m²) and 9 overweight (BMI > 27 kg/m²) men participated in a randomized controlled crossover trial. After consuming 3 cans of beer (40 g ethanol) or alcohol-free beer daily during 3 weeks, fasting blood samples were taken.

HDL cholesterol increased by 18.2% . Lipoprotein-associated phospholipase A2 activity was not different between beer (47.5 ± 0.8) and alcohol-free beer (48.9 ± 0.8). High-sensitive C-reactive protein was unaffected, but urinary isoprostanes tended to increase after beer (114.0 ± 6.9) compared to alcohol-free beer (96.9 ± 6.5).

An interaction between BMI and treatment on liver enzymes was observed, indicating an increase of liver enzymes after moderate alcohol consumption in overweight men only.

Despite profound effects on HDL and LDL cholesterol, moderate alcohol consumption did not affect lipoprotein-associated phospholipase A2 activity. Liver enzymes increased after alcohol consumption in overweight men only, suggesting a less favorable response to moderate alcohol consumption in overweight people.

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Request Reprint E-Mail: mailto:henk.hendriks@tno.nl
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Functional Consequences of GABA_A Receptor α4 Subunit Deletion on Synaptic and Extrasynaptic Currents in Mouse Dentate Granule Cells
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles) 7 Dec 2007

The α4 subunit-containing γ-aminobutyric acid (A) receptors (GABA_ARs) are highly expressed primarily at extrasynaptic sites in the dentate gyrus (DG) and thalamus and are suspected to contribute to tonic inhibition that is sensitive to potentiation by gaboxadol and ethanol (EtOH).

Global α4 subunit knockout (KO) mice exhibit greatly reduced tonic currents and insensitivity to ataxic, sedative and analgesic effects of gaboxadol compared to wild type (WT) controls. The α4 KO mice were also significantly more sensitive to pentylenetetrazol-induced seizures.

However, no differences were observed between α4 KO and WT mice in other baseline behaviors or in the effects of EtOH on these behaviors.

To examine possible functional and pharmacological GABA_AR alterations, and search for causes for the lack of differences in EtOH behaviors we studied the effects of acute EtOH application on GABA_AR-currents of DG cells from α4 KO and WT control mice complemented by Western blot measurements.

The magnitude of tonic current and its potentiation by EtOH (10 to 100 mM), alphaxalone (3 μM), and Ro15-4513 (0.3 μM) was greatly attenuated in α4 KO mice. The kinetics of miniature inhibitory postsynaptic currents (mIPSCs) in α4 KO mice were significantly slower compared to WT mice. Potentiation of mIPSCs by alphaxalone was greatly reduced in α4 KO mice. Ro15-4513 had no effect on mIPSCs from WT or KO mice. However, mIPSCs of α4 KO mice were significantly more sensitive to EtOH than those from WT mice. The γ2 subunit protein levels were selectively increased in hippocampus and thalamus, but not cortex of α4 KO mice.

These data suggest that the global loss of α4 subunits leads to region- and cell location-specific compensatory increases in γ2 subunits, which in turn alter the pharmacological sensitivity of synaptic and extrasynaptic GABA_AR-currents. Our data also suggests that while enhancement of tonic inhibitory currents by gaboxadol, alphaxalone, and EtOH are reduced, and behavioral sensitivity to gaboxadol and alphaxalone may be reduced, compensatory changes in synaptic GABA_AR subunits may prevent similar reductions in behavioral sensitivity to EtOH.

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Request Reprint E-Mail: igor@ucla.edu
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Children’s Introduction to Alcohol Use: Sips and Tastes
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles)7 Dec 2007

Sipping or tasting alcohol is one of the earliest alcohol use behaviors in which young children engage, yet there is relatively little research on this behavior.

The present research describes the prevalence of sipping or tasting in a community sample of children, examines the sociodemographic correlates and social contexts of this behavior, and tests whether variables reflecting psychosocial problem-behavior proneness, that predict adolescent drinking, account for this behavior.

Thirty-nine percent of the sample had only sipped or tasted alcohol (35% of 8 year olds and 48% of 10 year olds), while 6% reported having had a drink of alcohol (5% and 7%, respectively). African-American children were less likely than White children to be sippers. Neither gender nor mother’s education related to sipping status. Most sipping was done in a family context. Sipping/tasting did not generally relate to variables reflecting psychosocial proneness for problem behavior. Instead, the variables most predictive of sipping/tasting were perceived parents’ drinking status, perceived parents’ approval for child sipping, mother’s drinking frequency, and children’s attitudes toward sipping/tasting alcohol.

Young children’s sipping/tasting of alcohol reflects parental modeling of alcohol use and increased opportunities to try alcohol in the home rather than deliberate family socialization of alcohol use, and appears not to be a precocious manifestation of a psychosocial proneness to engage in problem behavior.

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Request Reprint E-Mail: donovanje@upmc.edu
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Time Trends in Heavy Drinking Among Middle-Aged and Older Adults in Denmark
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles) 7 Dec 2007

Studies have indicated an increasing proportion of heavy drinking among middle-aged and older Danes. Trends in consumption are often extremely sensitive to influence from various components of the time trends but only few have explored the age, period and cohort-related influences on late life alcohol consumption.

By using age, period, and cohort modeling this study explores the time trends in heavy drinking.

The unadjusted probability of heavy drinking declines by age and increases by calendar year and year of birth for both men and women. However, the negative effect of age is attenuated for women when adjusted for birth cohort, indicating that the proportion of heavy drinking women increases in younger birth cohorts. This trend is not observed for men as their drinking pattern mainly increase slightly by calendar year.

Our Danish observations for older aged individuals correspond to the social and cultural changes in the 1960s and 1970s that possibly have affected the drinking behavior of the cohorts. Time trend analyses, such as this may serve as an excellent opportunity to extrapolate and forecast alcohol mortality and morbidity.

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Request Reprint E-Mail: mg@niph.dk
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