Sober Housing and Motivational Interviewing: The Treatment Access Project

The Journal of Primary Prevention
Volume 28, Numbers 3-4 / August, 2007






This paper describes an innovative program that provides rental subsidies for sober housing and supportive services to persons in early recovery who are homeless and have substance use disorders.

Preliminary data point to the success of this program in enhancing recovery and exiting from homelessness.

In supporting sober house placements, the Treatment Access Project creates a bridge that supports these individuals in their transition from clinical treatment services to the community.

Integration with natural community supports can help to build self-efficacy, which can enhance the likelihood that this population will obtain and maintain abstinence, gainful employment, and permanent housing.


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News Release - Females More Prone To Brain Damage From Alcohol Abuse


( July 18, 2007)

OHSU, VAMC study on mice shows more brain cells die in females than males

PORTLAND, Ore. – Alcoholism has traditionally been considered a male disease because there are many more alcoholic males than females.

But a new study by researchers at Oregon Health & Science University and the Portland Veterans Affairs Medical Center suggests that women are more prone to brain damage from alcohol abuse than men.

The study led by Kristine Wiren, Ph.D., associate professor of behavioral neuroscience and medicine, OHSU School of Medicine, and research biologist, PVAMC Research Service, found that female mice are more susceptible to neurotoxic effects of alcohol withdrawal, including significantly increased brain cell death, than male mice. It also found the gender difference exists whether the animals are prone to severe withdrawal due to a genetic predisposition, or resistant to it.
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Alcohol Inhibits NR2B-Containing NMDA Receptors in the Ventral Bed Nucleus of the Stria Terminalis
Neuropsychopharmacology advance online publication 11 July 2007;




Components of the mesolimbic dopamine system, in particular dopaminergic cells in the ventral tegmental area (VTA), have been implicated in the acute reinforcing actions of ethanol. The ventral bed nucleus of the stria terminalis (vBNST) potently regulates dopaminergic cell firing in the VTA, and has been implicated in the behavioral actions of ethanol.

The N-methyl-D-asparate receptor (NMDAR) is a major molecular target of ethanol, however, current evidence suggests that ethanol regulation of NMDAR function is widely variable and likely depends on a number of factors. Thus, it is critical to investigate ethanol regulation of NMDAR function at synapses relevant to ethanol-regulated behaviors, such as in the vBNST.

Here we show, using multiple techniques, that ethanol inhibits NMDAR function in vBNST neurons in a postsynaptic fashion.

Further, we demonstrate the functional presence of both NR2A and NR2B-containing NMDARs in the vBNST. While genetic removal of NR2A did not alter the magnitude of ethanol inhibition, pharmacological blockade of NR2B rendered synaptically activated NMDARs insensitive to ethanol inhibition.

Finally, we demonstrate that ethanol inhibits NMDARs in cells in the vBNST that project to the VTA, providing a direct means by which ethanol in the vBNST can modulate the dopaminergic system.

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Reprint Request E-Mail: danny.winder@vanderbilt.edu
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Neurotoxic Consequences of Chronic Alcohol Withdrawal: Expression Profiling Reveals Importance of Gender Over Withdrawal Severity

Neuropsychopharmacology advance online publication 27 June 2007




While women are more vulnerable than men to many of the medical consequences of alcohol abuse, the role of sex in the response to ethanol is controversial. Neuroadaptive responses that result in the hyperexcitability associated with withdrawal from chronic ethanol likely reflect gene expression changes.

We have examined both genders for the effects of withdrawal on brain gene expression using mice with divergent withdrawal severity that have been selectively bred from a genetically heterogeneous population.

A total of 295 genes were identified as ethanol regulated from each gender of each selected line by microarray analyses. Hierarchical cluster analysis of the arrays revealed that the transcriptional response correlated with sex rather than with the selected withdrawal phenotype.

Consistent with this, gene ontology category over-representation analysis identified cell death and DNA/RNA binding as targeted classes of genes in females, while in males, protein degradation, and calcium ion binding pathways were more altered by alcohol.

Examination of ethanol-regulated genes and these distinct signaling pathways suggested enhanced neurotoxicity in females. Histopathological analysis of brain damage following ethanol withdrawal confirmed elevated cell death in female but not male mice. The sexually dimorphic response was observed irrespective of withdrawal phenotype.

Combined, these results indicate a fundamentally distinct neuroadaptive response in females compared to males during chronic ethanol withdrawal and are consistent with observations that female alcoholics may be more vulnerable than males to ethanol-induced brain damage associated with alcohol abuse.

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Reprint Request E-Mail: wirenk@ohsu.edu
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THE TRUTH ABOUT MIDTOWN

Welcome

We are a group of sober members of AA in the DC area and across the U.S. committed to exposing the Midtown Group (MG) as a cult posing within AA. Some of us are former members or loved ones of former members of the group.

It is our belief that the leaders of the MG utilize vulnerable young men and women to further their own security and status. Additionally, we believe that the allegations of statutory rape and sexual abuse are hallmarks of a destructive cult that needs to be stopped.

We are dedicated to stopping Midtown from using AA’s name to take advantage of vulnerable young newcomers who come through their doors seeking help from what they believe to be AA. We will not stop until DC area AA is back in the hands of real AA groups so that newcomers can find the help they need.
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Why Do Children from Socioeconomically Disadvantaged Families Suffer from Poor Health When They Reach Adulthood? A Life-Course Study
American Journal of Epidemiology Advance Access published online on July 19, 2007



The authors investigated what risk factors contribute to an excess risk of poor adult health among children who experience socioeconomic disadvantage.

Risk factors evaluated included a familial liability to poor health, childhood/adolescent health characteristics, low childhood intelligence quotient (IQ), exposure to childhood maltreatment, and adult SES.

Adult health outcomes evaluated at age 32 years were major depressive disorder, anxiety disorders, tobacco dependence, alcohol or drug dependence, and clustering of cardiovascular disease risk factors.

Results showed that low childhood SES was associated with an increased risk of substance dependence and poor physical health in adulthood (for tobacco dependence, for alcohol or drug dependence, for cardiovascular risk factor status.

Together, the risk factors studied here accounted for 55–67% of poor health outcomes among adults exposed to low SES as children. No single risk factor emerged as the prime explanation, suggesting that the processes mediating the link between childhood low SES and adult poor health are multifactorial.

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Reprint Request E-Mail: terrie.moffitt@iop.kcl.ac.uk
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Health Effects from Drinking: Type, Severity, and Associated Drinking Patterns Based on Qualitative and Quantitative Questions in a Methodological Survey

Substance Use & Misuse, Volume 42, Issue 5 April 2007 , pages 793 - 810




The specific content of reported health harms are explored in relation to heavy episodic drinking and alcohol dependence symptoms.

Among the 579 lifetime drinkers, 26% reported health harms from drinking. In multivariate logistic regression harms relating to intoxication, injuries or internal organs were associated with monthly heavy drinking (5+ drinks) and past dependence symptoms.

Study limitations are noted. Dependence symptoms should be assessed in screening for those most at risk for alcohol-related health harms.

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Reprint Request E-Mail: alown@arg.org
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Supermarkets selling cheap booze to young drinkers face Brown's iron fist


Jo Revill, Whitehall editor
Sunday July 22, 2007
The Observer

A crackdown on supermarkets that sell cheap drink to young people is being considered by Gordon Brown as he decides how to tackle Britain's burgeoning binge-drinking culture. Experts have told Downing Street that the easy availability of super-strength lager and cider lies behind the rise in alcohol-fuelled violence and the epidemic of related health problems, such as liver disease.

There is growing evidence that many young drinkers are consuming cheap alcohol at home before going out at night into bars and clubs, where prices can be three times as high. Around half of all Britain's drink sales are made at the six major supermarkets, where drink is often heavily discounted in order to encourage shoppers into the stores.
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Seeking Recovery, Finding Confusion
AA Group Leads Members Away From Traditions

By Marc Fisher

Washington Post Staff Writer
Sunday, July 22, 2007; Page A01

When Kristen was 17 and drinking out of control, her psychologist referred her to an Alcoholics Anonymous group that specialized in helping the youngest drinkers. In the Midtown Group, members and outsiders agree, young people could find new friends, constant fellowship, daily meetings, summer-long beach parties, and a charismatic leader who would steer them through sobriety.

But according to more than a dozen young people who structured their lives around the group, the unusual adaptation of AA that Michael Quinones created from his home in Bethesda became a confusing blend of comfort and crisis. They described a rigidly insular world of group homes and socializing, in which older men had sex with teenage girls, ties to family and friends were severed or strained, and the most vulnerable of alcoholics, some suffering from emotional problems, were encouraged to stop taking prescribed medications.
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Contributor: Don Phillips
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Call for higher alcohol taxes

Friday July 20, 200

Tax rises on alcohol should be imposed in order to reduce the damage caused to health, Chief Medical Officer Sir Liam Donaldson suggested.

Sir Liam, who is the senior medical adviser to the Government, said he would "strongly commend" the use of tax as a deterrent to excessive drinking, as has been the case with tobacco.

Speaking in the wake of reports suggesting that violent offences and attendances at hospital accident and emergency units have risen following the introduction of round-the-clock drinking, Sir Liam also said he would welcome a review of 24-hour licensing.
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Press release July 4, 2007 from Drug and Alcohol Findings

Drug and alcohol agencies now have free access to quality UK-focused ‘what works’ research as web-based service replaces Drug and Alcohol Findings magazine

Two open access web sites are being stocked with the entire contents of the past 15 issues of the Drug and Alcohol Findings magazine, the world’s only periodical to focus on research which could improve the effectiveness of substance misuse services. One site is the Findings site itself (http://findings.org.uk) where visitors can sign up for e-mail updates on the project.

The longer term plan is to create an ‘Effectiveness Bank’ site which will also provide access source research papers and abstracts. Reports on new studies will be added to keep visitors up to date with the latest findings.

Funded initially by the J. Paul Getty Jr. Charitable Trust, the project is a joint venture between DrugScope, Alcohol Concern, the National Addiction Centre and the project’s editor.

By mid-June 2007 the first issue of the magazine had been made available on the Findings site and more will regularly be added. Though in its early stages, the site has been described as “Awesome!” by Professor John Kelly, researcher and clinician at the USA’s Massachusetts General Hospital and Harvard University. In the UK Gary Wallace who manages Plymouth’s Drug and Alcohol Action Team says Findings “helped us sift relevant research and identify evidence from around the world that has significantly informed our change processes … an essential tool”.

It’s not so much the design of the site which has enthused as the quality of the content. The Findings magazine gained an international reputation for the thoroughness and creativity of its analyses. Now these riches (the core contents are called ‘Nuggets’ for a reason) are being made available free of charge and at the click of a button.

For the Effectiveness Bank, national drug information experts DrugScope are constructing a customised search facility so visitors can easily find the documents they need. The aim is to provide a one-stop resource which draws on the accumulated information banks of the Findings partner agencies and the high quality content of the magazine. DrugScope’s Director of Communications Harry Shapiro is managing this part of the project: “If services want to use proven methods to improve their effectiveness, the Effectiveness Bank is where they should come to.”

Alcohol Concern made the bid to the Getty Trust on behalf of the project. “Findings is about changing what people do, not just discussing it”, said Director of Policy and Services Don Shenker. “That means we have to get it right. Quality in the science and analysis is everything but it also has to practice-friendly. The trick Findings has pulled off is to meet both agendas at once.”

Partnership with the National Addiction Centre makes the centre’s huge information resources available to the project. “The magazine was right at the time”, said Research Coordinator John Witton, “but the world has moved on. Now people expect to find information instantly and to get it free. When it comes to information which could make things better for their communities, clients, patients children, that’s exactly what they should get.”

Contributor: Mike Ashton e-mail: editor@findings.org.uk
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NineZero Conference
Sponsored by
Fetal Alcohol Spectrum Disorders
Task Force of Santa Clara County
ninezeroconference@gmail.com

Friday, September 7, 2007

Keynote Speaker: Ira Chasnoff, MD
WORKSHOPS OFFERED:
(full descriptions)

• FASD Diagnosis
• Screening for Perinatal Substance Abuse
  
• Criminal Justice System and FASD
  
• Foster Care/Adoption & FASD
• Mental Health Issues & FASD
  
• Perinatal Substance Abuse Treatment Providers in Santa Clara County
  
• FASD 101
  
• Educating Teens (F.A.S.T.R.A.C. Curriculum/9-0 Campaign)

Read More

Contributor: Peggy Seo Oba
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(Registration begins at 8:00 AM)

Foetal Alcohol-Syndrome & Interrelated Treatment Help



The Beyers Truter Foetal Alcohol-Syndrome and Interrelated Treatment Help Fund (FAITH) is a new Section 21 company geared to tackle one of the most serious issues in the winelands head-on.

The FAITH Fund will operate as a non-profit organisation and a credible vehicle for raising funds through various activities, and to distribute donations for specific projects, charities and other organisations working with children, families and communities affected by alcohol abuse, with a particular focus on Foetal Alcohol Syndrome.

Because it is known to be the foremost preventable reason for mental retardation and birth defects in such cases, the Beyers Truter Faith Fund recognises the importance of health education in reducing the number of alcohol-exposed births. The FAITH Fund pledges to fund the implementation of innovative ideas in advocacy, prevention, education and intervention.
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Read More

Contributor: Peggy Seo Oba

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Wednesday, July 18, 2007

SAMHSA's Road to Recovery Update The Road to Recovery Update keeps you informed about activities leading up to National Alcohol & Drug Addiction Recovery Month (Recovery Month) in September. Feel free to forward this information to friends and colleagues, include it in newsletters or listservs, or link to it from your Web site. Last Chance to Submit a Question to the Expert For the July Webcast Get answers to your questions about the topics covered in the latest Road to Recovery Webcast "Treatment and Recovery: Reducing the Burden on the Justice System and Society." Submit your questions using our anonymous online form, and answers from our expert will be posted in early August. Visit Ask the Expert before July 20 to submit questions for this month's expert: Roger H. Peters, Ph.D., Chair and Professor, Department of Mental Health Law and Policy, University of South Florida, Louis de la Parte Florida Mental Health Institute Next Webcast View the Trailer Wednesday, August 1: "Improving the Bottom Line: Supporting Treatment Profits Employers and Employees" Addiction to drugs and/or alcohol does not just stay in the home; it often spreads into the workplace, causing decreased performance and lower profitability. In 2002, drug use disorders alone contributed to a loss of productivity amounting to $128.6 billion in the United States. (Source: The Economic Costs of Drug Abuse in the United States: 1992-2002. Pub. No. 207303. Washington, D.C.: Executive Office of the President, Office of National Drug Control Policy, 2004, p. X) Moreover, because an addicted individual is often quite adept at hiding his or her addiction, employers and even coworkers may not be able to recognize what is causing the individual’s decreased productivity at the office. Addiction issues do not just cause problems for the individual’s work environment, but his or her family members may be having problems at their workplaces as well. Join Ivette Torres, Associate Director for Consumer Affairs, Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) and a panel of experts to examine the issues related to addiction in the workforce such as: how to identify where a problem exists, when to intervene and how, and what can be done. This program will also demonstrate how employee assistance programs are beneficial to the addicted individual, their family members, and the company. Give People a Voice for Recovery! Do you know someone who is celebrating recovery? Let them know that they have a voice! Because the successes of individuals in recovery are often overlooked by society, Voices for Recovery gives people the opportunity to share their stories with others and provides education for the general public about treatment for alcohol and drug addiction. Click here to share your story! About Recovery Month National Alcohol and Drug Addiction Recovery Month, celebrating 18 years of observance in 2007, is an initiative of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT). For more information about Recovery Month, visit www.recoverymonth.gov. __________________________________________________________________

Challenges of diagnosis in fetal alcohol syndrome and fetal alcohol spectrum disorder in the adult
American Journal of Medical Genetics Part C: Seminars in Medical Genetics
Early View 19 July 2007



Adults with fetal alcohol syndrome (FAS) and the subsets of individuals with attenuated phenotype subsumed under the umbrella term of fetal alcohol spectrum disorder (FASD) provide clinicians with a challenge.

Compounding this, FASD is different from most genetic syndromes since a specific diagnostic biological test is not available.

The diagnosis first needs to be suspected and confirmation requires a diagnostic assessment that is best carried out in the context of a multi-disciplinary team approach.

There is surprisingly little research published on the prevalence, natural history, medical, and social complications relevant to adults with FASD. The evidence that is emerging suggests that this disorder is common, and that services to diagnose and treat these individuals are limited.

Adults with FASD have a higher incidence of impairments in social adaptive and executive function, and a higher degree of psychopathology when compared to the general population. The impact of FASD has significant and serious effects on those affected with FASD, their families, and our communities.

There is a need for improved access to diagnosis, and more research and evaluation of interventions currently in use.

In this paper, we describe the current diagnostic criteria, the differential diagnosis, the prevalence, natural history, the behavioral and mental health consequences, medical and social management issues, and interventions for adults affected with this disorder.

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Reprint Request E-Mail: achudley@hsc.mb.ca
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Lesbians, Gays, and Alcoholism Treatment: Challenges to Recovery

Veronica Jeffus, M.Ed., Therapist
Gatehouse Therapeutic Health Services

For many years, it has been the general assumption that the incidence of alcoholism was much higher for gays and lesbians than in the heterosexual population. Early studies reported that as high as 35% of gays and lesbians were excessive or problem drinkers vs. five percent of heterosexuals. (Saghir and Robins, 1973) Later reported estimates of alcohol use among homosexuals tended to remain at the 30% mark, vs. the 10% usually cited for the general population. It was not until researchers began an investigation of the methodology of the early studies that important information began to emerge. Samples for early research efforts were recruited largely in gay bars and their surroundings, given that these are one of the few public places where gays can feely socialize as a group. However, heavy drinkers are also more likely to congregate in bars than are social drinkers or abstainers. Additionally, bars are also a frequent venue for other drug use. For these reasons, early studies whose research protocols relied heavily on patrons of gay bars were at risk to overestimate the prevalence of alcohol and drug use among gay men and lesbians.
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Violent crime, disorder and criminal damage since the introduction of the Licensing Act 2003

Home Office Online Report 16/07


Penny Babb

Summary

• A subset of 30 forces in England and Wales provided data for violent crimes, disorder and criminal damage offences recorded between October 2004 and September 2006. Of these forces, 18 also provided data for offences recorded as occurring at specified locations such as city centres and in or near licensed premises.

• The numbers of more serious violent crimes fell in the year after the introduction of the Licensing Act in November 2005 compared with the previous year, with the decreases occurring particularly in the evening hours before midnight, but with increases between 3am and 6am.

• A fall also occurred in less serious wounding offences in the year after the Act. The number of these offences had been rising prior to the Act.

• There is an indication of some increase between the hours of 3am and 6am for each offence group, but the total offences in this time period account for only a very small proportion of the 24-hour total (four per cent in the year to November 2006).

• The rise from 3am and up to 6am is likely to partly reflect the change to opening hours of licensed premises and the increased numbers of people in a public place at these times, including the police, with greater resources being placed on the streets to deal with disorder.

• There was no overall percentage change in the number of assault without injury offences occurring in the night-time period in the year following the introduction of the Act for the 30 forces, though in this instance the overall figure for England and Wales indicated an estimated increase of five per cent. While the levels fell in the early evening, there was a rise in the early hours of the morning. This pattern of assault with no injury recording may have been influenced by the widening of the powers of arrest in January 2006.

• The numbers of harassment offences showed a rise in the year preceding the introduction of the Act, in part driven by the increased use of penalty notices for disorder. The increase continued after the Act came in and was greater for offences occurring in the night-time period than during the day.

• In the police force areas covered by this study, there was a small (two per cent) increase in criminal damage offences occurring after 9pm in the year following the introduction of the Act, even though overall criminal damage fell slightly (One per cent).

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24-hour drinking leads to surge in violence
By Toby Helm and John Steele
Drink to blame as violence rises by 5pc

Government claims that all-night drinking would create a relaxed Mediterranean cafe culture and cut alcohol-related crime were shattered yesterday as figures showed that early morning violent offences had soared since 24-hour licensing.

A Home Office report disclosed that offences of assault, criminal damage and harassment between 3am and 6am rose sharply in the 12 months after the reforms came in. The figures are a blow to ministers who had argued that staggered and later closing times would reduce crime levels by avoiding the traditional 11pm rush on to the streets, which often resulted in ugly clashes between drunken revellers and police.
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Hazelden Foundation survey reveals disparity between severity of problem and employer assistance

CENTER CITY, MINN. (July 17, 2007)

-- A national survey of human resources professionals conducted by the nonprofit Hazelden Foundation shows that while substance abuse and addiction are recognized as among the most serious problems faced in the workplace, employer policies and practices are not fully addressing the problem.

The survey also found that although most companies offer employee assistance programs, many do not openly and proactively deal with employee substance abuse issues, do not refer employees to treatment programs and face barriers that prevent them from helping employees seek and receive addiction treatment.

The survey of more than 1,000 senior human resource professionals provides an in-depth look at HR professionals’ knowledge of substance abuse and addiction in the workplace and the roles they play in helping both employers and employees identify and address this serious public health issue.
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Read National Survey Highlights (PDF)
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January 2008 conference, Engaging States and Local Communities in Prevention Policies

Sunday - Wednesday, January 27 - 30, 2008
The Bahia Resort Hotel, Mission Bay, San Diego, California

Call for presentation proposals

Deadline: Monday, August 20, 2007

The California Council on Alcohol Policy (Cal Council), a statewide non-profit uses education, community organizing and public policy to reduce the problems associated with alcohol that impact our communities. We are pleased to sponsor the January 2008 conference, Engaging States and Local Communities in Prevention Policies. This conference is the 14th in a series of national and regional meetings that address research, policy, and prevention issues related to alcohol. We welcome an anticipated attendance of up to 300 participants including community-based practitioners, public officials, and researchers from across the North America and beyond.

Contributor: Tom Colthurst

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