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, March 27, 2007

Drinking in Context: Patterns, Interventions, and Partnerships

(Edited by Gerry Stimson, Marcus Grant, Marie Choquet, and Preston Garrison)


Press Kit

We are pleased to announce the publication of a new book, Drinking in Context: Patterns, Interventions, and Partnerships. This book lays out a pragmatic approach to alcohol policy development that relies on drinking patterns, the need for targeted interventions for the reduction of harm, and partnerships among all those with a role to play. It was co-sponsored by the International Center for Alcohol Policies (ICAP), the International Harm Reduction Association (IHRA), World Federation for Mental Health (WFMH), and the Institut de Recherches Scientifiques sur les Boissons (IREB).

The book was launched globally on March 27, 2007, in London at the Houses of Parliament. The African book event took place in Nairobi, Kenya, on March 20, 2007; and a Japanese-language edition of Drinking in Context will be unveiled in Tokyo on April 24, 2007.

Raise age limit for buying alcohol to 21 and cut death toll - doctors

RUSSELL JACKSON

ALCOHOL sales should be restricted to over-21s, according to a new report that reveals that the drug is killing tens of thousands of teenagers and young adults in the developed world.

One in four deaths of people aged 15 to 29 in the developed world is down to drink - a total of 82,000 fatalities a year.


Males accounted for 70,000 of those deaths, meaning alcohol is responsible for a third of deaths among young men in the developing world, the Adolescent Health Study, published by the Lancet, revealed.

The figure is made up of mainly accidents when the victims are inebriated, such as swimmers drowning and drink-driving deaths.

At the launch of the study in London yesterday, doctors called for the legal age for buying alcohol to be raised to 21.

Dr Russell Viner, a paediatrician at University College London, said Britain had only just woken up to the alcohol problem, which was most prevalent in northern Europe, Australia and New Zealand.

He said: "We are recognising that binge drinking in young people is a serious problem. We thought it was a lot of fun, but we now realise that, particularly amongst young people, not drinking much all week and splurging at the weekend is harmful."

He said the solution was to raise the legal limit for buying alcohol to that in the United States, where the number of young people drinking has been falling for 20 years.

He went on: "I would like to see a European model where most young people drink with their family at a younger age, learning to drink in a social context. But it would be difficult to bolt this on to established Anglo-Saxon practice, so the best is probably what Americans do. We need a rethink of ages we license young people to buy various products."

The report, a collection of several studies from around the world, claims brain development continues through adolescence and can be placed at risk by the use of alcohol.

It claims that zero-tolerance approaches to alcohol are ineffective, and that harm-reduction strategies, such as random breath-testing and early intervention from GPs advising youngsters on the risks of alcohol consumption, can be more effective.

The study says that, partly as a result of alcohol misuse, there is a danger of a substantial drop in life expectancy, with chronic diseases, such as diabetes and early signs of cardiovascular disease, appearing in teenagers and young adults.

Professor Glenn Bowes, the head of the paediatric department at the University of Melbourne in Australia, said alcohol misuse was likely to cause further problems later in life.

Citing the statistic that 98 per cent of adult drinkers began drinking in their adolescence, he said: "Adults who have alcohol-related health issues often exhibit behaviour patterns that began in their teenage years.

"Preventive work needs to be done at the stage where the behaviour starts," he added.

"The education in school is important, but we really have to look at what the health system is doing. Doctors need to be shown how to talk to adolescents, so that when they come in to a GP's surgery with a cold, for example, the doctor can use it as an opportunity to ask them about their lifestyle and advise them on the health risks."

Adolescent Health: an opportunity not to be missed

Today's generation of adolescents is the largest in history—nearly half of the world's population is less than 25 years old—and they face far more complex challenges to their health and development than their parents did. Many young people today are living with HIV/AIDS or depression—the leading causes of disease burden for adolescents worldwide. And hazardous alcohol use now accounts for 86% of the 8·6 million substance related deaths of 15-29-year-olds globally.

The Lancet's Adolescent Health Series was launched in London on March 26. You can hear the expert panel highlighting the key elements of the series by listening to the audio files below:

Lancet Editor Richard Horton introduces the briefing and the guest speakers (MP3 file, 2.9 MB)

'Glimmers of hope'. Glenn Bowes from the Royal Children's Hospital, Melbourne, Australia outlines the context for the series, and emphasises how adolescent health is now a defined health specialty where evidence-based research should drive policy changes (MP3 file, 6.8 MB)

'Adolescent mortality is now higher than childhood mortality'. Series co-ordinator Russell Viner from the Institute of Child Health, London, UK, discusses morbidity and mortality trends among adolescents and discusses the widening gap between biological and social adult maturation (MP3 file, 10.1 MB)

'What young people actually want'. Andre Tylee from King's College London, UK focuses on the role of primary care and mental health issues in relation to adolescent health (MP3 file, 8.5 MB)

'Services should be accessible and acceptable to young people'. Dagmar Haller from Geneva University Hospital, Switzerland discusses the implementation of youth-oriented health programmes (MP3 file, 7.1 MB)

The launch concludes with 30 mins of lively discussion in a questions and answers forum (MP3 file, 31.5 MB)

READ COMPLETE LIST OF ARTICLES

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Series, Adolescent Health


Interventions to reduce harm associated with adolescent substance use

SUMMARY

A major proportion of the disease burden and deaths for young people in developed nations is attributable to misuse of alcohol and illicit drugs. Patterns of substance use established in adolescence are quite stable and predict chronic patterns of use, mortality, and morbidity later in life. We integrated findings of systematic reviews to summarise evidence for interventions aimed at prevention and reduction of harms related to adolescent substance use. Evidence of efficacy was available for developmental prevention interventions that aim to prevent onset of harmful patterns in settings such as vulnerable families, schools, and communities, and universal strategies to reduce attractiveness of substance use. Regulatory interventions aim to increase perceived costs and reduce availability and accessibility of substances. Increasing price, restricting settings of use, and raising legal purchase age are effective in reducing use of alcohol and tobacco and related harms. Screening and brief intervention are efficacious, but efficacy of a range of treatment approaches has not been reliably established. Harm-reduction interventions are effective in young people involved in risky and injecting substance use.

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Monday, March 26, 2007

Globalization of Behavioral Risks Needs Faster Diffusion of Interventions


International trade, population migration, changes in living conditions (i.e., consumption transition, nutritional transition), and changes in production, marketing, and availability of consumer goods (i.e., production transition) have brought about continuous and rapid changes in the human environment. Such changes have improved the health and economic status of many people in developing countries.

At the same time, a parallel phenomenon is occurring: the rapid emergence and expansion of modifiable risk behaviors. These behaviors adversely affect the national health of developing countries and that of future generations because of their impact on maternal, child, and adolescent health. Furthermore, these behaviors are increasing at a faster rate than interventions to curb their growth are being implemented.

We discuss the current status of five modifiable risk behaviors — alcohol consumption, tobacco use, overweight and obesity, low fruit and vegetable consumption, and physical inactivity — to emphasize the need for global advocacy and local action to enhance policy formulation and diffusion of interventions necessary to moderate the spread of these behaviors.

(more) . . . .

READ FULL TEXT

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A Newsletter for Professionals Spring 2007


Bringing Up the Touchy Subject of a Patient’s Drinking

Broaching the subject of alcohol with a patient or client who shows signs of a drinking problem can be awkward. Drinkers often feel ashamed of their problem, at the same time that they downplay its seriousness. Directly confronting them may do no more than provoke
a flat denial. For these reasons professionals very often steer clear of the matter. But to wait for that patient or client to bring up the subject amounts to giving up on the issue, according to some with first-hand experience in the matter.
more). . . .

READ FULL NEWSLETTER (PDF)

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Outcomes for young adults with fetal alcohol syndrome


To test the hypothesis that fetal alcohol syndrome (FAS), with the full phenotype, and fetal alcohol effect (FAE), with some but not all of the features, can be combined under the umbrella term fetal alcohol spectrum disorders (FASD).

The devastating effects of intrauterine exposure to alcohol persist into early adulthood and severely limit careers and independent living.

READ FULL ABSTRACT

REPRINT REQUEST E-MAIL: h.spohr@drk-kliniken-westend.de

Contributor Peggy Seo Oba

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NEWS RELEASE -
Most first-time offenders for driving while intoxicated need help for more than just alcohol


Public release date: 26-Mar-2007

Contact: Rebekka S. Palmer, Ph.D.

rebekka.palmer@yale.edu
203-781-2777, ext. 144
Yale University School of Medicine

Mary E. Larimer, Ph.D.
larimer@u.washington.edu
206-543-3513
University of Washington

Alcoholism: Clinical & Experimental Research

Most first-time offenders for driving while intoxicated need help for more than just alcohol

Most first-time offenders for driving while intoxicated need help for more than just alcohol

  • Driving while intoxicated (DWI) is a significant public-health problem in the US.
  • New findings indicate that many first-time DWI offenders also have high rates of other substance-use disorders as well as other psychiatric disorders.
  • Intervention programs may need to provide enhanced services to help this more severe subtype of DWI offenders.
Driving while intoxicated (DWI) is a significant public-health problem in the US. In 2005, according to the Department of Transportation, there were 16,885 alcohol-related fatalities; roughly 40 percent of all fatal car accidents are alcohol-related.

New findings indicate that because most first-time DWI offenders also have high rates of other substance-use disorders as well as other psychiatric disorders, intervention programs may need to provide enhanced services to help this more severe subtype of DWI offenders.

. . . .
READ FULL RELEASE

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NEWS RELEASE -
Children with attention deficit hyperactivity disorder at risk for alcohol problems


Public release date: 26-Mar-2007

Contact: Jocelyn Uhl Duffy

uhljh@upmc.edu
412-647-3555
University of Pittsburgh

Stephen Hinshaw, Ph.D.
hinshaw@berkeley.edu
510-643-8586
University of California Berkeley

Alcoholism: Clinical & Experimental Research

Children with attention deficit hyperactivity disorder at risk for alcohol problems

Parental alcoholism and family stress can also facilitate the development of alcohol problems

  • Prior research has shown that children with ADHD can develop alcohol problems later in life.
  • Two studies confirm this association, indicating that drinking problems begin around age 15.
  • Parental alcoholism and family stress appear to add to the risk of children with ADHD developing alcohol problems themselves.
Researchers believe that children with attention deficit hyperactivity disorder (ADHD) are at risk for alcohol- as well as other substance-related problems as they grow older. Yet the research is not always consistent. Two new studies help to confirm that ADHD is a risk factor for alcohol problems; adding that parental alcoholism and stressful experiences in the family play an important role in this risk.
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READ FULL RELEASE

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NEWS RELEASE -
Sequence variation in the alpha synuclein gene contributes to alcohol craving



Public release date: 26-Mar-2007

Contact: Tatiana M. Foroud, Ph.D.

tforoud@iupui.edu
317-278-1291
Indiana University School of Medicine

Alison Goate, D. Phil.
goate@icarus.wustl.edu
314-362-8691
Washington University, St. Louis

Alcoholism: Clinical & Experimental Research

Sequence variation in the alpha synuclein gene contributes to alcohol craving

  • The protein alpha synuclein (SNCA) plays an important role in the regulation of dopamine function.
  • Craving is a common symptom in alcoholics.
  • New findings show that sequence variation in the gene that encodes SNCA contributes to whether or not an individual craves or does not crave alcohol.
READ FULL RELEASE

Many Infants Prenatally Exposed to High Levels of Alcohol Show One Particular Anomaly of the Corpus Callosum



Effects of prenatal alcohol exposure on the brain are seen at every age. The earlier they can be quantified, the better the prognosis for the affected child. Here we show measurable alcohol effects at birth on a structure currently used for nosology only much later in life.

An average of the images for the unexposed subjects has the geometry of textbook images of normal babies; but the average for the subgroup of high-angle subjects may serve as a template or guide to this regional damage parallel to the familiar photographic exemplars that help to assess facial signs.

READ FULL ABSTRACT

Reprint requests E-mail: flb@stat.washington.edu

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The Alcohol-Induced Suppression of Ovarian Insulin-Like Growth Factor-1 Gene Transcription Is Independent of Growth Hormone and Its Receptor

Insulin-like growth factor-1 (IGF-1) plays an important role in ovarian development and function.

Alcohol (ALC) is a gonadal toxin and capable of causing depressed ovarian IGF-1 and suppressed estradiol. The mechanism by which ALC affects IGF-1 transcription is not well understood, and more information is needed to better understand the interrelationships between ALC, growth hormone (GH) and its ovarian receptor, and the gene expression of ovarian IGF-1.

These results suggest that the ALC-induced suppression of ovarian IGF-1 gene transcription is independent of alterations in serum GH.

READ FULL ABSTRACT

Reprint requests E-mail: vsrivastava@cvm.tamu.edu

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Gender Differences in Neurocognitive Functioning Among Alcohol-Dependent Russian Patients



There are a limited number of studies that have examined gender differences in the neurocognitive test performances of alcohol-dependent individuals. Those that have been conducted reported that compared with men, women's visuospatial skills, psychomotor speed, and working memory are more profoundly affected by chronic alcohol abuse despite a shorter duration of drinking and a lesser quantity of alcohol consumed.

The data support and extend prior research demonstrating a more deleterious impact of alcohol dependence on female alcoholic subjects' cognitive functioning compared with male alcoholic subjects. Several theories are offered to account for gender differences in neurocognitive performance.

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Reprint requests E-mail: bflannery@rti.org

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Adrenocorticotropic Hormone/Cortisol Response to Physical Exercise in Abstinent Alcoholic Patients



Alterations in the hypothalamic–pituitary–adrenal (HPA) axis in alcoholic patients have been reported in various experimental conditions.

In concurrence with previous reports showing alterations of the HPA axis in the central nervous system in alcohol-dependent subjects, these data show a defect of the neuroendocrine mechanism(s) underlying the ACTH/cortisol response to physical exercise for at least a month after alcohol withdrawal, with reconstitution of a normal hormonal response at 8 weeks.

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Reprint requests E-mail: vittorio.coiro@unipr.it

Chronic Alcohol Consumption Is Associated With Changes in the Distribution, Immunophenotype, and the Inflammatory Cytokine Secretion Profile of Circulating Dendritic Cells


Alcoholism is frequently associated with altered immune responses, limited information being available on its effects on dendritic cells (DC). In the present study we analyze the effects of chronic alcoholism on circulating DC.

Chronic alcoholism in the absence of liver disease is associated with an increased secretion of inflammatory cytokines by PB DC, whereas ALCAW and ALCET patients show decreased numbers of circulating DC and reduced secretion of these cytokines, respectively.

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Reprint requests E-mail: laso@usal.es

Ethanol Intake in the Juvenile, Adolescent, and Adult Rat: Effects of Age and Prior Exposure to Ethanol



Initial ingestion of ethanol by naïve rats has seemed to decrease dramatically with age. During the preweanling period, infant rats consume large quantities of high concentrations of ethanol without initiating procedures, in some instances exceeding doses required for severe motor incoordination. During adulthood, however, initial ingestion of ethanol without initiation procedures is low and infrequent.

Using the consume off the floor technique with blood ethanol concentrations as an estimate of intake, absolute ethanol consumption seems to be quite high early in ontogeny and decline gradually into adulthood.

Adding saccharin to ethanol solutions at the concentration used in the present study (0.1%) was generally not sufficient to increase absolute ethanol intake from the floor, except during adulthood.

The experimental strategy employed in this study represents a novel approach for examining ethanol acceptance patterns across ontogeny and how experience with the process of intoxication affects subsequent ethanol preferences.

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Reprint requests E-mail: nspear@binghamton.edu

Bidirectional Alterations of Hippocampal Cannabinoid 1 Receptors and Their Endogenous Ligands in a Rat Model of Alcohol Withdrawal and Dependence


The hippocampus is strongly implicated in memory processes and contains high concentrations of both cannabinoid receptors and their endogenous ligands. Chronic alcohol consumption impairs a variety of cognitive and performance tasks, including memory and learning. As the activation of cannabinoid receptors by their endogenous ligands modulates hippocampal neurotransmission, we hypothesized that the impaired memory and learning in alcoholism may be due to alterations in the hippocampal endocannabinoid system.

These data demonstrate that CIE treatment and withdrawal transiently down-regulates hippocampal CB1Rs followed by a long-term up-regulation, including increased levels of endogenous cannabinoids.

These findings are consistent with our hypothesis and suggest that long-term up-regulation of hippocampal CB1Rs may contribute to the long-term cognitive impairments in alcoholism.

The data further suggest that the effectiveness of CB1R blockade in decreasing alcohol consumption may be greater after protracted abstinence from alcohol.

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Reprint requests E-mail: igor@ucla.edu

Difluoromethylornithine Decreases Long-Lasting Protein Oxidation Induced by Neonatal Ethanol Exposure in the Hippocampus of Adolescent Rats


Ethanol exposure and withdrawal during central nervous system development can cause oxidative stress and produce severe and long-lasting behavioral and morphological alterations in which polyamines seem to play an important role. However, it is not known if early ethanol exposure causes long-lasting protein oxidative damage and if polyamines play a role in such a deleterious effect of ethanol.

These results suggest that the hippocampus is selectively affected by early ethanol exposure and by polyamine synthesis inhibition. In addition, the results suggest a role for polyamines in the long-lasting increase of protein carbonyls induced by ethanol exposure and withdrawal.

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Reprint requests E-mail: dabcns@uky.edu

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Investigating Gender Differences in Alcohol Problems: A Latent Trait Modeling Approach




Inconsistent results have been found in research investigating gender differences in alcohol problems. Previous studies of gender differences used a wide range of methodological techniques, as well as limited assortments of alcohol problems.

Significant gender differences were found in approximately one-third of the symptoms assessed and in the overall scale. Further examination of the nature of gender differences in alcohol problem symptoms should be undertaken to investigate whether a gender-neutral scale should be created or if men and women should be assessed with separate criteria for alcohol dependence and abuse.


READ FULL ABSTRACT

REPRINT REQUESTS E-MAIL: nich0185@umn.edu

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Senate proposes higher beer tax


HELENA — Anheuser-Busch Cos. joined retailers and distributors from around Montana today in opposing a bill to more than double the state excise tax on beer produced by large breweries.

Money raised by the tax hike proposed by Sen. Christine Kaufmann, D-Helena, would pay for drug- and alcohol-treatment and -prevention programs, as well as the state Children’s Health Insurance Program.

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