0% drink driving (resolution)

That this meeting of RCN Congress urges Council to lobby for legislation which reduces to zero the permissible level of alcohol intake before driving.

As statistics show an increasing number of deaths or serious injuries related to drink-driving incidents, Carol Evans from the Cambridgeshire branch urged members to consider the need to change the law to reduce the permissible level of alcohol intake before driving to zero. She highlighted the public’s confusion surrounding the number of units currently allowed but noted that most people choose their drink not based on units but rather on colour, price and taste.

The resolution was seconded by Andy Frazer from the RCN Emergency Care Association who told members that in his work he had seen the results of many drink driving incidents. “You wouldn’t drink two pints of beer before going to work?” he asked Congress delegates, “a car is potentially a lethal weapon,” he warned. . . . . .

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NTA release national alcohol statistics report

'From 1st April 2008, the Department of Health commissioned the NTA to collect and analyse alcohol treatment data on its behalf using the NDTMS. This subset of the NDTMS is known as the National Alcohol Treatment Monitoring System (NATMS). NATMS forms a key part of The Department’s Alcohol Improvement Programme.

Download the NATMS Annual Statistical report 2008/2009

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A Comparison of Two Different Approaches to Characterizing the Heterogeneity Within Antisocial Behavior: Age-of-Onset versus Behavioral Sub-Types

There are two common approaches to sub-typing the well-documented heterogeneity within antisocial behavior: age-of-onset (i.e., child-onset versus adolescent-onset; see Moffitt, 1993) and behavioral (i.e., physical aggression versus nonaggressive rule-breaking).

These approaches appear to be intimately connected, such that aggression is particularly characteristic of child-onset antisocial behavior whereas rule-breaking is largely specific to adolescent-onset antisocial behavior (see Moffitt, 2003). Even so, it remains unclear which approach, if either, substantively drives these different manifestations of antisocial behavior.

We examined this question in a sample of 1,726 adults in treatment for alcoholism, evaluating the two approaches in regards to their prediction of anger and alcohol dependency.

Although age-of-onset predicted both outcomes when analyzed alone, these associations fully dissipated once we controlled for aggression and rule-breaking.

Such findings suggest that the behavioral sub-types may prove to be a stronger predictor of antisocial behavior outcomes than is age-of-onset.

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Request Reprint E-Mail: burts@msu.edu.


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Physical functional health predicts the incidence of coronary heart disease in the European Prospective Investigation into Cancer-Norfolk prospective

Little is known about the relationship between physical functional health and long-term risk of coronary heart disease (CHD) independently of known risk factors in a general population.

Men and women aged 40–79 years at baseline who completed a health and lifestyle questionnaire and attended a health examination during 1993–97 participating in the European Prospective Investigation into Cancer-Norfolk who were free of myocardial infarction (MI), stroke and cancer were included. Eighteen months later, physical functional health was assessed using physical component summary (PCS) scores of Short-Form 36-item questionnaire (SF-36). The incidence of CHD was ascertained by death certification and hospital record linkage up to March 2008.

A total of 14 222 men and women were included in the study. There were 389 incident CHD (total person-years = 126 896 years). People who reported better physical functional health had significantly lower risk of CHD. Using Cox proportional hazard models adjusting for age, sex, body mass index, cholesterol, systolic blood pressure, smoking, alcohol consumption, physical activity, diabetes, family history of MI, social class and aspirin usage, it was found that men and women who were in the top quartile of SF-36 PCS had half the risk of CHD [relative risk (RR) = 0.46; 95% confidence interval (CI) = 0.32–0.65] compared with the people in the bottom quartile. The relationships remained essentially unchanged after excluding incident CHD within the first 2 years of follow-up (RR = 0.48; 95% CI = 0.33–0.70).

Physical functional health predicts subsequent CHD risk independently of known risk factors in a general population. People with poor physical functional health may benefit from targeted preventive interventions.

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Request Reprint E-Mail: phyo.k.myint@uea.ac.uk

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B.C. announces ‘toughest’ drunk-driving laws in country

Two years ago, four-year-old Alexa Middelaer was killed by an alleged drunk driver as she fed a horse on a road in Delta. Yesterday her mother, Laurel Middelaer, hugged B.C.’s solicitor general and thanked him for a “gutsy” new law to make British Columbia the worst place in the country to get caught driving while impaired.

Solicitor General Mike de Jong said the law introduced yesterday honours the memory of Alexa by aiming to reduce the number of drunk driving fatalities by a third in the next three years.

“We need penalties that are clear, swift and severe,” Mr. de Jong said on the steps of the legislature, flanked by a dozen uniformed police officers, top officials from Mothers against Drunk Driving, and Alexa’s parents.

The new law, which will take effect this fall, gives police the authority to impose tougher roadside penalties for drivers who refuse a breath sample or are found with a blood alcohol level over the legal limit of 0.08 per cent. Drivers face an immediate, 90-day driving ban and a $500 fine plus their vehicle can be impounded for 30 days. They may also face criminal charges.

The new rules also create a “warning” category for drivers with blood alcohol levels between 0.05 and 0.08 per cent. Penalties include an immediate, three-day driving ban and a $200 fine for a first-time offence.

In both cases, drivers will pay more to restore their driving privileges, up to $3,750 following any roadside suspension. . . . . .

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Industry cool on proposals to restrict alcohol sales

THE DRINKS industry has expressed concern about new proposals to restrict the sale of alcohol which are emerging as part of the Government’s strategy for tackling substance abuse.

Draft proposals being examined by the steering group include minimum prices for alcoholic drinks, new charges on retailers selling large volumes and laws requiring alcohol to be sold separately from other products, The Irish Times understands.

The plans are being drawn up by the National Substance Misuse Strategy Steering Group, which the Government set up last year to draw up a new approach for dealing with alcohol misuse along the lines of actions being taken under the National Drugs Strategy. . . . . .

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Genome-wide association identifies candidate genes that influence the human electroencephalogram

Complex psychiatric disorders are resistant to whole-genome analysis due to genetic and etiological heterogeneity.

Variation in resting electroencephalogram (EEG) is associated with common, complex psychiatric diseases including alcoholism, schizophrenia, and anxiety disorders, although not diagnostic for any of them. EEG traits for an individual are stable, variable between individuals, and moderately to highly heritable.

Such intermediate phenotypes appear to be closer to underlying molecular processes than are clinical symptoms, and represent an alternative approach for the identification of genetic variation that underlies complex psychiatric disorders.

We performed a whole-genome association study on alpha (α), beta (β), and theta (θ) EEG power in a Native American cohort of 322 individuals to take advantage of the genetic and environmental homogeneity of this population isolate.

We identified three genes (SGIP1, ST6GALNAC3, and UGDH) with nominal association to variability of θ or α power.

SGIP1 was estimated to account for 8.8% of variance in θ power, and this association was replicated in US Caucasians, where it accounted for 3.5% of the variance. Bayesian analysis of prior probability of association based upon earlier linkage to chromosome 1 and enrichment for vesicle-related transport proteins indicates that the association of SGIP1 with θ power is genuine.

We also found association of SGIP1 with alcoholism, an effect that may be mediated via the same brain mechanisms accessed by θ EEG, and which also provides validation of the use of EEG as an endophenotype for alcoholism.


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Request Reprint E-Mail: chodg@mail.nih.gov.


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Moderate Ethanol Preconditioning of Rat Brain Cultures Engenders Neuroprotection Against Dementia-Inducing Neuroinflammatory Proteins: Possible Signal

There is no question that chronic alcohol (ethanol) abuse, a leading worldwide problem, causes neuronal dysfunction and brain damage.

However, various epidemiologic studies in recent years have indicated that in comparisons with abstainers or never-drinkers, light/moderate alcohol consumers have lower risks of age-dependent cognitive decline and/or dementia, including Alzheimer’s disease (AD). Such reduced risks have been variously attributed to favorable circulatory and/or cerebrovascular effects of moderate ethanol intake, but they could also involve ethanol “preconditioning” phenomena in brain glia and neurons.

Here we summarize our experimental studies showing that moderate ethanol preconditioning (MEP; 20–30 mM ethanol) of rat brain cultures prevents neurodegeneration due to β-amyloid, an important protein implicated in AD, and to other neuroinflammatory proteins such as gp120, the human immunodeficiency virus 1 envelope protein linked to AIDS dementia.

The MEP neuroprotection is associated with suppression of neurotoxic protein-evoked initial increases in [Ca⁺²]_i and proinflammatory mediators—e.g., superoxide anion, arachidonic acid, and glutamate.

Applying a sensor → transducer → effector model to MEP, we find that onset of neuroprotection correlates temporally with elevations in “effector” heat shock proteins (HSP70, HSP27, and phospho-HSP27). The effector status of HSPs is supported by the fact that inhibiting HSP elevations due to MEP largely restores gp120-induced superoxide potentiation and subsequent neurotoxicity.

As upstream mediators, synaptic N-methyl-d-aspartate receptors may be initial prosurvival sensors of ethanol, and protein kinase C epsilon and focal adhesion kinase are likely transducers during MEP that are essential for protective HSP elevations.

Regarding human consumption, we speculate that moderate ethanol intake might counter incipient cognitive deterioration during advanced aging or AD by exerting preconditioning-like suppression of ongoing neuroinflammation related to amyloidogenic protein accumulation.

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Request Reprint E-Mail: mcollin@lumc.edu


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Childhood antecedents of adult violent offending in a group of female felons

The purpose of this study was to evaluate potential antecedents of violent felony arrest in a sample of female felons.

Among male populations, early onset conduct disorder (CD) with progression to adult anti-social personality disorder (ASPD) is associated with increased criminality and aggression. Conduct disorder is associated with a worsened trajectory of alcohol dependence in men. These factors likely have a synergistic contribution to male adult violent offending.

Existing work suggests that CD, ASPD, and severe alcohol dependence may represent an externalizing endophenotype, which is, at least in part, genetically conferred. These associations have not been well studied in female populations.

The author examined a sample (N = 130) of female mid-sentence felons to determine associations between adult arrest for violent felony with child and young adult antecedents, including CD and alcohol dependence. Data were gathered through administration of the Semi-Structured Assessment for the Genetics of Alcoholism II (SSAGA II).

CD had high prevalence (40.8%), as did ASPD (31.4%) and alcohol dependence (43.8%). Women convicted of violent felonies were more likely to have CD with progression to ASPD, and alcohol dependence. Both alcohol dependence and CD were independently associated with violent offending.

These data suggest that the most serious female offenders have psychopathology similar to that of males and that the trajectory of disease and etiology of violent behavior may not be as gender specific as previously presumed.

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Request Reprint E-Mail: catlewis@uchc.edu


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Combined effect of alcohol consumption and lifestyle behaviors on risk of type 2 diabetes

It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers’ healthier lifestyles.

We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-risk lifestyle behaviors.

We prospectively examined 35,625 adults of the Dutch European Prospective Investigation into Cancer and Nutrition (EPIC-NL) cohort aged 20–70 y, who were free of diabetes, cardiovascular disease, and cancer at baseline (1993–1997). In addition to moderate alcohol consumption (women: 5.0–14.9 g/d; men: 5.0–29.9 g/d), we defined low-risk categories of 4 lifestyle behaviors: optimal weight [body mass index (in kg/m²) >30 min of physical activity/d), current nonsmoker, and a healthy diet [upper 2 quintiles of the Dietary Approaches to Stop Hypertension (DASH) diet].

During a median of 10.3 y, we identified 796 incident cases of type 2 diabetes. Compared with teetotalers, hazard ratios of moderate alcohol consumers for risk of type 2 diabetes in low-risk lifestyle strata after multivariable adjustments were 0.35 (95% CI: 0.17, 0.72) when of a normal weight, 0.65 (95% CI: 0.46, 0.91) when physically active, 0.54 (95% CI: 0.41, 0.71) when nonsmoking, and 0.57 (95% CI: 0.39, 0.84) when consuming a healthy diet.

When 3 low-risk lifestyle behaviors were combined, the hazard ratio for incidence of type 2 diabetes in moderate alcohol consumers after multivariable adjustments was 0.56 (95% CI: 0.32, 1.00).

In subjects already at lower risk of type 2 diabetes on the basis of multiple low-risk lifestyle behaviors, moderate alcohol consumption was associated with an 40% lower risk compared with abstention.

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Request Reprint E-Mail: j.beulens@umcutrecht.nl .

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UK remains amongst top EU countries for binge drinking

A report 'EU citizens’ attitudes towards alcohol' has been released, continuing to show the UK and Ireland in particular as having the highest reported rates of binge drinking (EU definition* of five drinks or more on any one occasion). According to the report:

'Alcohol consumption in the EU is at a similar level to four years ago. Binge drinking (five drinks or more on any one occasion) affects all ages but young people aged 15-24 years are the most likely to binge drink every week.' . . . .

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Media Release - Study: Victorians aren’t aware alcohol causes cancer Call on

Call on govt review panel for better alcohol labelling

VIC: Research released today shows half of all Victorians don’t realise that alcohol causes cancer, prompting the Alcohol Policy Coalition to call for health advisory labels on all alcohol products to better inform consumers.

The Council of Australian Governments is today holding a public meeting in Melbourne to discuss overhauling Australia’s food and alcohol labelling laws.

“People need to know what they are drinking and how it can impact their health so that they can make an informed decision about the drinks they purchase and consume,” said Craig Sinclair, Director of the Cancer Prevention Centre, Cancer Council Victoria.

The VicHealth survey of 1,500 Victorians showed one in four people don’t believe that alcohol is a cause of cancer, while another twenty-five percent said they weren’t sure. . . . . .

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Prevalence of alcohol abuse and alcoholism in general population of Mostar region, Bosnia and Herzegovina.

The aim of this study was to determine the prevalence of alcohol abuse and alcoholism in the general population of Mostar region, Bosnia and Herzegovina.

This study was conducted on a stratified sample of 704 participants. The prevalence of alcohol abuse was determined using standardized questionnaire on alcohol consumption--Michigan Alcoholism Screening Test.

Prevalence of alcohol abuse with high risk for alcoholism was 9.9% and prevalence of alcohol addiction was 2.1%. In student population, there were 3.9% of alcohol addicts and 11.1% of persons with high risk of alcoholism. In high school population, there were 1.7% of alcohol addicts and 14.4% of persons with high risk of alcoholism.

In Mostar region there was a high prevalence of alcoholism and problematic drinking, especially in high school and student population.

There is a need for extensive preventive measures that have to include education, early diagnosis and intervention.


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Request Reprint E-Mail: helena.skobic@tel.net.ba



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Alcohol Taxes and Birth Outcomes

This study examines the relationships between alcohol taxation, drinking during pregnancy, and infant health.

Merged data from the US Natality Detailed Files, as well as the Behavioral Risk Factor Surveillance System (1985–2002), data regarding state taxes on beer, wine, and liquor, a state- and year-fixed-effect reduced-form regression were used.

Results indicate that a one-cent ($0.01) increase in beer taxes decreased the incidence of low-birth-weight by about 1–2 percentage points. The binge drinking participation tax elasticity is −2.5 for beer and wine taxes and −9 for liquor taxes.

These results demonstrate the potential intergenerational impact of increasing alcohol taxes.


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Socio-economic status predicts drinking patterns but not alcohol-related consequences independently

To identify independent relationships between socio-economic status and drinking patterns and related consequences and to identify socio-economic groups at risk for heavier consumption.

Three comparable national telephone surveys were utilized: 1995, 2000 and 2004. The respondents were aged 18–65 years. Contextual information includes that a number of liberalized alcohol policy changes occurred over the time of the surveys.

Educational qualification, income and occupation were associated independently with alcohol consumption. There were indications that the different dimensions of drinking (quantity and frequency) had different relationships with socio-economic status (SES). For example, lower SES groups drank heavier quantities while higher SES groups drank more frequently. SES, however, did not play a major role predicting drinking consequences once drinking patterns were controlled for, although there were some exceptions. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population (as they had sustained increases in the quantities they consumed over time where other SES groups did not).

Socio-economic status was related independently to drinking patterns and there re indications that SES interacted differently with the different dimensions of drinking (quantity and frequency). For the most part, socio-economic status was not related independently to the experience of alcohol-related consequences once drinking patterns were accounted for. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population.

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Request Reprint E-Mail: t.huckle@massey.ac.nz


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Striatal Dysfunction Marks Preexisting Risk and Medial Prefrontal Dysfunction Is Related to Problem Drinking in Children of Alcoholics

Parental alcoholism substantially raises risk for offspring alcoholism, an effect thought to be mediated by a dysregulation in impulse control. Adult alcoholics have alterations in the frontostriatal system involved in regulating impulsive responses. However, it remains controversial whether these alterations reflect preexisting traits predisposing to problem alcohol use or are secondary to alcohol involvement.

Sixty-one 16 to 22 year olds were tested using a go/no-go task during functional magnetic resonance imaging. Forty-one were family history positive (FH+), having at least one parent with a diagnosis of alcohol use disorder (AUD), and 20 were family history negative (FH−). Two FH+ subgroups were created to disentangle alcohol involvement from preexisting risk: the FH+ control group (n = 20) had low alcohol problems, differing from the FH– group only by family history. The FH+ problem group (n = 21) had high alcohol problems.

The ventral caudate deactivated during successful inhibition in the FH– but not the FH+ groups, regardless of problem alcohol involvement. Regression analyses showed that ventral caudate deactivation was related to fewer externalizing problems as well as to family history. Orbital and left medial prefrontal regions were deactivated in both the FH– and FH+ control groups but not the FH+ problem group. Activation in these regions was associated with alcohol and other drug use.

These findings suggest a preexisting abnormality in ventral striatal function in youth at risk for AUD, which may lead to inappropriate motivational responding, and suggest that with alcohol use, the prefrontal “control” mechanism loses efficiency, further dysregulating the frontostriatal motivational circuitry.

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Request Reprint E-Mail: mheitzeg@umich.edu


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The Impacts of Liquor Outlets in Manukau City Summary Report

There has been significant recent debate over the impact of liquor outlets on communities in New Zealand.

This report summarises the key results from a research project undertaken between 2008 and 2010.

Media analysis and research with community stakeholders confirm that the issue is a focus of concern among communities in New Zealand.

In Manukau City, off-licence liquor outlets tend to be located in areas of high social deprivation and high population density, while on-licence liquor outlets tend to be located in main centres and areas of high amenity value. Higher off-licence density is associated with lower alcohol prices and longer opening hours.

The density of both off-licence and onlicence liquor outlets is associated with a range of social harms, including various police events and motor vehicle accidents.

However, these results are context specific and care should be taken in applying them to other locations.

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Alcohol In Our Lives: Curbing the Harm

'Alcohol In Our Lives: Curbing the Harm' (NZLC R114, Wellington 2010) is the Commission’s final report on the review of New Zealand’s liquor laws. The terms of reference for the review required the Commission to consider a broad range of issues including: the adequacy of the current liquor licensing laws; alcohol taxation and pricing; advertising; age restrictions and the responsibilities of parents with respect to adolescent drinking.

The report contains 153 recommendations to Government and is divided into four parts. Part 1 summarises the public consultation findings and outlines the case for legal reform; Part 2 sets out the detailed framework for a new licensing system; Part 3 deals with alcohol taxation and pricing and the promotion of alcohol and Part 4 addresses alcohol offences, education and treatment.

The 32 page extracted Summary of the full report can be downloaded separately.

A limited number of hardcopies are available for purchase. The Report was tabled in Parliament on 27 April 2010. Review of the Regulatory Framework for the Sale and Supply of Liquor Submissions Analysis

A separate report on the 2,939 public submissions on the Commission’s Issues Paper, ('Alcohol In Our Lives' (NZLC IP15, Wellington 2009) is also available. This 48 page report prepared by independent consultants, Litmus, contains an analysis of all 2,939 submissions across seven key policy areas: licensing; opening hours; purchase/drinking age; off-licences; tax and price; advertising and drinking in a public place. It also contains an in depth analysis of different stakeholder positions across the full range of policy options.

The policies analysed in this report are those that were put forward as provisional options for public debate in the Commission’s Issues Paper published in July 2009.


Download Report Summary and Chapters PDF's


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Report recommends 10pc rise in alcohol price

Raising the price of alcohol by 10 per cent and closing bars and restaurants by 4am are among a raft of recommendations to the Government made by the Law Commission.

The Commission's report, tabled in Parliament at midday, also included the anticipated recommendation of raising the alcohol purchasing age to 20.

Labelling alcohol reform as a "social battleground", the Law Commission has made 153 recommendations to the Government on liquor law reforms.

The Commission analysed the current liquor licensing system, alcohol pricing and promotions, the responsibility of parents and the negative effects of alcohol on health and crime statistics. . . . . .

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Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women

Physical activity, diet, smoking, and alcohol consumption have been shown to be related to mortality. We examined prospectively the individual and combined influence of these risk factors on total and cause-specific mortality.

The prospective cohort study included 4886 individuals at least 18 years old from a United Kingdom–wide population in 1984 to 1985. A health behavior score was calculated, allocating 1 point for each poor behavior: smoking; fruits and vegetables consumed less than 3 times daily; less than 2 hours physical activity per week; and weekly consumption of more than 14 units of alcohol (in women) and more than 21 units (in men) (range of points, 0-4). We examined the relationship between health behaviors and mortality using Cox models and compared it with the mortality risk associated with aging.

During a mean follow-up period of 20 years, 1080 participants died, 431 from cardiovascular diseases, 318 from cancer, and 331 from other causes. Adjusted hazard ratios and 95% confidence intervals (CIs) for total mortality associated with 1, 2, 3, and 4 poor health behaviors compared with those with none were 1.85 (95% CI, 1.28-2.68), 2.23 (95% CI, 1.55-3.20), 2.76 (95% CI, 1.91-3.99), and 3.49 (95% CI, 2.31-5.26), respectively (P value for trend, <.001). The effect of combined health behaviors was strongest for other deaths and weakest for cancer mortality. Those with 4 compared with those with no poor health behaviors had an all-cause mortality risk equivalent to being 12 years older.

The combined effect of poor health behaviors on mortality was substantial, indicating that modest, but sustained, improvements to diet and lifestyle could have significant public health benefits.

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Request Reprint E-Mail: ekvaavik@medisin.uio.no

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