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, January 15, 2008

Effect of chronic alcohol consumption on brain damage following transient focal ischemia
Brain Research, Article in Press, Corrected Proof 7 December 2007



Chronic alcohol consumption impairs cerebral vasoreactivity, and thus, may result in an increase in ischemic brain damage.

The goal of this study is to examine the influence of chronic alcohol consumption on transient focal ischemia-induced brain damage.

Dilation of pial arterioles in response to hypoxia and hypercapnia was significantly reduced in alcohol-fed rats. Alcohol-fed rats had significantly larger infarct volumes and worse neurological outcomes than non-alcohol-fed rats under ketamine/xylazine or isoflurane anesthesia. In addition, rCBF measurement indicated that alcohol-fed rats had less regulatory rebound increase in rCBF after the initial drop in rCBF at the onset of MCAO.

Our findings suggest that chronic alcohol consumption exacerbates transient focal ischemia-induced brain damage. Increased ischemic brain damage during alcohol consumption may be related to an impaired cerebral vasoreactivity.

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Request Reprnit E-Mail: hsu1@unmc.edu
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Differential effects of acute alcohol on EEG and sedative responses in adolescent and adult Wistar rats
Brain Research, Article in Press, Corrected Proof 4 Dec 2007


Age-related developmental differences in sensitivity to the acute effects of alcohol may play an important role in the development of alcoholism.

The present study was designed to evaluate the acute effects of alcohol on cortical electroencephalogram (EEG) in adolescent (P36) and adult (P78) Wistar rats.

Five minutes of EEG was recorded after administration of 0, 0.75 or 1.5 g/kg alcohol. The righting reflex was performed to measure the sedative effects of alcohol (3.5 g/kg) and total sleeping time for each rat.

Our results showed that alcohol (1.5 g/kg) increased power in the 1–2 Hz band and decreased the power in the 32–50 Hz band in the parietal cortical region of adolescent rats. Alcohol (1.5 g/kg) also increased stability of the EEG power in the slow-wave frequency bands (2–4 Hz, 4–6 Hz, and 6–8 Hz) of adolescent rats. In the frontal cortex of adult rats, but not in adolescent rats, alcohol (1.5 or 0.75 g/kg) decreased the power in the 16–32 Hz frequency band.

Alcohol (1.5 g/kg) differentially increased power in a multiple of slow-wave frequency bands (2–4 Hz and 4–6 Hz) in the parietal cortex of adult rats as compared to adolescent rats. Adolescent rats were shown significantly shorter sleeping time and higher blood alcohol levels after regaining reflex than adult rats.

Our results provide additional evidence of age-related differences in the effects of acute alcohol on cortical EEG, sedation and tolerance.

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Request Reprint E-Mail: cindye@scripps.edu
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Socioeconomic Differences in Alcohol-Specific Parenting Practices and Adolescents' Drinking Patterns
European Addiction Research 2008;14:26-37


The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income.

The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking.

A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other.

Some moderating effects of SES were found.


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Request Reprint E-Mail: R.Spijkerman@pwo.ru.nl

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College Students' Drinking Patterns: Trajectories of AUDIT Scores during the First Four Years at University
European Addiction Research 2008;14:11-18


Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers.

In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories.

The pattern of changes in risk consumption is similar to that found in corresponding US studies.

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Request Reprint E-Mail: kent.johnsson@med.lu.se
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Socioeconomic Differences in Alcohol-Specific Parenting Practices and Adolescents' Drinking Patterns
European Addiction Research 2008;14:26-37

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income.

The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking.

A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other.

Some moderating effects of SES were found.


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Request Reprint E-Mail: R.Spijkerman@pwo.ru.nl

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New DASIS Report: Male Admissions with Co-occurring Psychiatric and Substance Use Disorders: 2005

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Office of Applied Studies (OAS) has released a new DASIS Report titled, Male Admissions with Co-occurring Psychiatric and Substance Use Disorders: 2005. The report provides statistical analysis on co-occurring disorders and the effects of such on substance abuse disorders in males.

The following are some highlights from the report:

  • Among male admissions reporting alcohol, cocaine, marijuana, or stimulants as the primary substance of abuse, those with co-occurring disorders were more likely than those without co-occurring disorders to report daily use of these substances
  • Sixty-two percent of male admissions with co-occurring disorders reported more than one substance of abuse compared with 52 percent of male admissions without co-occurring disorders
  • Male admissions with co-occurring disorders were more likely than those without co-occurring disorders to report five or more prior substance abuse treatment episodes (17 vs. 10 percent)
Download Report (PDF)
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Monday, January 14, 2008

American Indian and Alaska Native Mental Health Research
The Journal of the National Center
Volume 14, Number 3, 2008




MENTAL HEALTH, HEALTH, AND SUBSTANCE ABUSE SERVICE
NEEDS FOR THE NATIVE AMERICAN REHABILITATION ASSOCIATION NORTHWEST (NARA NW) IN THE PORTLAND, OREGON METROPOLITAN AREA
pp. 1-23

Consistent with results of previous needs assessments for urban American Indian and Alaska Native populations, a needs assessment in the Portland, Oregon metropolitan area for the Native American Rehabilitation Association Northwest revealed high levels of co-occurring conditions for American Indian and Alaska Native clients, often combining chronic health problems, substance abuse histories, and mental health diagnoses. Focus group results suggest the need for crisis care as well as specifi c needs of children and families, veterans, elders, and adults.

PREDICTORS OF RELAPSE FOR AMERICAN INDIAN WOMEN AFTER SUBSTANCE ABUSE TREATMENT
pp. 24-48

The objective of this study was to describe the predictors of substance use relapse of American Indian (AI) women up to one year following substance abuse treatment. Relapse is defi ned as any use of alcohol or drugs in the past 30 days at the follow-up points. Data were collected from AI women in a 45-day residential substance abuse treatment program. Predictors include distal (in time) proximal (recent), and intrapersonalfactors. Results indicated that intrapersonal factors showed the strongest relationship with relapse, followed by proximal and distal factors. Negative messages about using alcohol or drugs from the client's father while growing up may have had an impact on whether the client used alcohol at 6 months. Conflicts with other people and being in the company of alcohol or drug users were highly predictive of relapse. While craving was highly predictive of substance use at follow up, self-efficacy was highly predictive of no substance use. Knowledge about predictors of relapse among this population should be used as a guide toward individual treatment planning.

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Web-based self-help for problem drinkers: a pragmatic randomized trial
Addiction 103 (2), 218–227.

Self-help interventions for adult problem drinkers in the general population have proved effective. The question is whether this also holds for self-help interventions delivered over the internet.

At follow-up, 17.2% of the intervention group participants had reduced their drinking successfully to within the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI) 1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weekly alcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI 5.9–18.1; P <>

To our knowledge this is one of the first randomized controlled trials on a web-based self-help intervention without therapist guidance for self-referred problem drinkers among the adult general population. The intervention showed itself to be effective in reducing problem drinking in the community.

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Request Reprint E-Mail: hriper@trimbos.nl

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[Commentary] A HARD NATURAL EXPERIMENT TO FATHOM: A TESTAMENT TO THE INCREASING DIFFICULTY OF CONDUCTING RELIABLE SURVEYS?
Addiction 103 (2), 192–193.

The paper by Mäkelä et al. [1] adds to the important tradition of studying ‘natural experiments’ in alcohol policy, a tradition that is especially strong in the Scandinavian countries [2]. Had the results followed the almost invariable pattern that reduced taxes lead to increased consumption, there would have been much less over which to discuss and puzzle. The authors are to be applauded for publishing these unexpectedly negative results. Arguably, studies such as this have unique value by forcing the field to question received wisdom and, I suggest, also traditional research methods.
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Changes in volume of drinking after changes in alcohol taxes and travellers' allowances: results from a panel study
Addiction 103 (2), 181–191.

The aim of this paper is to study short-term changes in alcohol consumption by subgroups of the population in Denmark, Finland and southern Sweden following large-scale decreases in alcohol taxation in Denmark and Finland and large increases in travellers' allowances in Finland and Sweden.

Consumption decreased or remained the same among women and men in all three study sites. Relative changes were similar across subgroups of age, gender and income in all countries. In absolute terms, there was a consistent differential change by age in Denmark, Finland and Southern Sweden, with the higher level of the young and lower level of the old converging. Women's and men's consumption converged in Finland and southern Sweden. The changes did not differ systematically by income. Changes were not larger among heavier drinkers.

The results did not confirm expectations: an increase in consumption larger than that in the control site could not be shown in any of the countries or subgroups of the population. If there has been an effect – as shown in aggregate data in Finland – it seems to have been stronger among the old than the young and, in Finland and southern Sweden, among women rather than men.


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Request Reprint E-Mail: pia.makela@stakes.fi
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Current Issue: January-March 2008
Differences in delta- and mu -Opioid Receptor Blockade Measured by Positron Emission Tomography in Naltrexone-Treated Recently Abstinent Alcohol-Dependent Subjects
Neuropsychopharmacology (2008) 33, 653–665


Blockade of brain mu-opioid receptor (mu-OR) and delta-opioid receptor (delta-OR) was investigated in recently abstinent alcohol-dependent subjects (N=21) maintained on naltrexone.

Naltrexone inhibition of [11C]CAR BP was near maximal across all brain regions of interest with little variability across subjects (mean+SD% inhibition=94.9+4.9%). Naltrexone only partially inhibited the [11C]MeNTI Ki and there was more variability across subjects (mean+SD% inhibition=21.1+14.49%).

Peak serum levels of naltrexone were positively correlated with % inhibition of delta-OR Ki in neocortex and basal ganglia. Peak serum levels of naltrexone were not correlated with % inhibition of mu-OR BP. Peak levels of 6-beta-naltrexol were not significantly correlated with % inhibition of mu-OR BP or delta-OR Ki.

Thus, the FDA recommended therapeutic dose of naltrexone was sufficient to produce near complete inhibition of the mu-OR in recently abstinent alcohol dependent subjects. The lower percent inhibition of delta-OR and greater variability in delta-OR blockade by naltrexone across subjects may contribute to individual differences in treatment outcomes to naltrexone.

Further investigations on the relationship between individual differences in delta-OR blockade by naltrexone and clinical outcomes should be explored.

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Request Reprint E-Mail: eweerts@jhmi.edu
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Pharmacological Evidence for a Motivational Role of kappa-Opioid Systems in Ethanol Dependence
Neuropsychopharmacology
(2008) 33, 643–652


The purpose of this study was to test the hypothesis that activation of the dynorphin/kappa (kappa)-opioid system has a role in the increased consumption of ethanol in dependent animals.

The effects of three opioid receptor antagonists with different effects on opioid receptors, naltrexone, nalmefene, and nor-binaltorphimine (nor-BNI), were compared in their ability to decrease ethanol self-administration in nondependent and ethanol-dependent male Wistar rats.

The results indicated that both nalmefene and naltrexone induced a significant dose-dependent decrease in the number of lever presses for ethanol in both groups of animals. However, in ethanol-dependent animals, nalmefene was significantly more effective in suppressing ethanol intake than naltrexone. Nor-BNI selectively attenuated ethanol-dependent self-administration while leaving nondependent ethanol self-administration intact. Because naltrexone is primarily selective for the mu-opioid receptor, and nalmefene is primarily selective for the mu- and kappa-opioid receptor subtypes, the fact that nalmefene demonstrates more suppression in dependent animals suggests that opioid systems distinct from the mu-regulated portion may be involved in the increased drinking seen during withdrawal in dependent animals.

The results with nor-BNI confirm that kappa-opioid receptor antagonism selectively decreases dependence-induced ethanol self-administration, which supports the hypothesis that dynorphin/kappa-opioid systems are dysregulated in dependence and contribute to the increased drinking seen during acute withdrawal in dependent rats.

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Alcohol Preference Influences the Subthalamic Nucleus Control on Motivation for Alcohol in Rats Neuropsychopharmacology (2008) 33, 634–642;


In addition to its role in motor and attentional processes, the subthalamic nucleus (STN) has also been recently demonstrated to be involved in motivational function. Indeed, bilateral STN lesions modulate differentially the motivation for natural rewards and drugs of abuse, increasing motivation for food and decreasing motivation for cocaine in rats.

Here, we show that in outbred rats, the STN can modulate the motivation for alcohol according to alcohol preference, without affecting alcohol intake.

When performed on 'High-Drinker' rats, STN lesions enhanced the breaking point (BP) under a progressive ratio schedule of reinforcement and increased the time spent in the environment previously paired with alcohol access in the place preference paradigm. In contrast, when performed on 'Low-Drinker' rats, STN lesions decreased the BP and increased the time spent in the environment paired with water.

These results show that STN lesions enhance the motivation for alcohol in rats showing a high alcohol preference, whereas they decrease it in rats showing a low preference for alcohol

These results suggest that the STN plays a complex role in the reward circuit, that is not limited to a dissociation between motivation for natural rewards and drugs of abuse, but takes other factors, such as alcohol preference, into account.

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Request Reprint E-Mail: cbaunez@up.univ-mrs.fr
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Sunday, January 13, 2008

12-Step Treatment for Alcohol and Substance Abuse Revisited: Best Available Evidence Suggests Lack of Effectiveness or Harm
International Journal of Mental Health and Addiction Onlione First 11 Jan 2008


Approaches incorporating 12-Step beliefs and practices have dominated substance abuse treatment despite a lack of empirical support.

Recent claims for effectiveness relying on results from a large, multisite research project in the U.S. were re-evaluated based on critical analysis of design, methodology, and construction of outcome measures.

Contrary to claims, experimental design did not allow comparison of effectiveness of 12-Step versus cognitive–behavioral interventions but does allow evaluation of outcome measures for a single treatment intervention infused with 12-Step beliefs and teachings.

Corrected for design and methodological errors, results support estimated “remission” rates for alcohol abuse of at most 15–20% and for substance abuse of 0–15%.

Elements inherent in 12-Step practices and beliefs, including step work, run counter to accepted counseling and therapeutic factors believed to predict positive outcomes. Lack of effectiveness or outcomes less beneficial than no treatment are thus not unexpected for courses of treatment infused with 12-Step elements.

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Request Reprint E-Mail: millerz@eoni.com
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Saturday, January 12, 2008

[Commentary] DIFFERENT PATHWAYS TO KNOWLEDGE ABOUT DIFFERENT PATHWAYS TO RECOVERY: A COMMENT ON THE PEOPLE AWAKENING STUDY
Addiction 103 (2), 216–217.

The People Awakening (PA) study [1] illustrates the value of studying drinking problems in culturally diverse groups with methodologies that fit the research questions and the cultural context of inquiry. The study's qualitative, participatory methods were well suited for an initial exploration of how Alaskan Natives (AN) initiate and maintain sobriety. It is unlikely that quantitative or experimental methods would have been accepted initially or that they would have provided the rich data set upon which the authors developed their heuristic model of recovery.

The study thus exemplifies evidentiary pluralism [2], an approach that selects research methods in service of content questions, and not the other way around. Hypothesis-generating studies such as the PA project that use qualitative methods are appropriate when knowledge is developing, and the goal is to form proper questions for future research. Forcing quantitative or experimental methods prematurely can delay knowledge development, whereas well-conducted qualitative studies can propel it forward.
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Friday, January 11, 2008

Editorial - About smoke and mirrors: the alcohol industry and the promotion of science
Addiction 103 (2), 175–178.


This editorial was prompted by the publication of Drinking in Context: Patterns, Interventions, and Partnerships [1], a book emerging from a collaboration between four organizations: the International Harm Reduction Association, the World Federation for Mental Health, the International Center for Alcohol Policies (ICAP) and the Institut de Recherches Scientifiques sur les Boissons. This is not the first time that some of these organizations have come together. The International Harm Reduction Association supports the ‘Dublin Principles’, which proposes working cooperation between the alcohol industry and ‘governments, and the scientific and academic community’ (http://www.icap.org/BuildingPartnerships/DublinPrinciples/tabid/249/Default.aspx). The ‘Principles’ result from a collaboration between the National College of Ireland, ICAP and the Institut de Recherches, which is also a participant in the creation of the ‘Principles’. These two latter organizations acknowledge their sponsorship by the alcohol industry.

The book is organized into 10 chapters, addressing drinking patterns, assessment of drinking, targeted and tailored interventions, alcohol-impaired driving, public disorder related to drinking, drinking by young people, interventions minimizing harm, key players and partnerships and ‘finding common ground’. Although four ‘authors’ are listed on the front cover of the book (G. Stimson, M. Grant, M. Choquet & P. Garrison), each from one of the partnering organizations, 22 other individuals are identified as ‘contributing authors’. These come from a variety of organizations, including those already mentioned above, plus universities and the alcohol industry.

The authorship arrangement deserves some attention because it is rather unusual. Further information in the book's ‘Foreword’ indicates that there was also an ‘Editorial Advisory Group’ with 15 of the 26 authors, which met twice ‘under the chairmanship of Professor Norman Sartorius’ (who is not listed as an author). This group produced the overall plan for the book and reviewed a draft manuscript. This draft was produced under the ‘guidance’ of the main editor, Professor Stimson, who wove together the ‘many contributions, some greater, some smaller’ from the other authors. According to the Foreword, this process created a ‘sense of collective responsibility’, which ‘led to the decision not to attribute authorship of particular chapters to particular individuals’. This may have been the case, but as can be inferred from the description herein it has also resulted in a rather obfuscating process that does not seem to reflect accepted authorship attributions, which implies creative input, individual ownership and public responsibility for the contents of the chapters.

Concerns about previous attempts such as this one to promote scientific research in the alcohol field by the alcohol industry have already been identified [2]. While attempting to produce this type of ‘scientific work’, the alcohol industry continues to behave unethically [3]. Industry practices in marketing and advertising (e.g. flavored malt beverages) have been identified as a potential factor triggering an ‘industrial epidemic’ of alcohol problems [4]. Unethical behavior is also present in developing countries where profit maximization is the industry's main goal [5–7]. In the paragraphs below I try to look beyond the smoke and mirrors, to describe the apparent underlying intentions behind the book, the harms this specific effort can trigger and puzzlement at why some alcohol scientists continue to participate in these efforts.
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Drinking places: Where people drink and why

Gill Valentine, Sarah L Holloway, Mark Jayne and Charlotte Knell


The links between alcohol and where people drink it in two contrasting communities.

It is well-established that attitudes to alcohol vary by social group, but there is little research on how geography affects these attitudes.

This report investigates where people drink alcohol and why in two contrasting communities, one urban and one rural. Looking at a range of drinking, from abstinence to bingeing, the project:

  • explores how socio-economic processes shape local drinking cultures;
  • evaluates the benefits and problems associated with alcohol use;
  • examines how attitudes to and use of alcohol vary across social groupings both within and between the two communities;
  • explores how attitudes have changed between generations and the impact of local history on those attitudes;
  • identifies the policy implications of the local specificity of drinking cultures.

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Press Release - Lenihan announces new Initiative on Alcohol

Department of Justice, Equality and Law Reform

9 January 2008

The Minister for Justice, Equality and Law Reform, Mr Brian Lenihan T.D., announced today that the Government has approved his proposal to establish an Advisory Group to urgently examine key aspects of the law governing the sale and consumption of alcohol.

Membership of the Advisory Group, which will hold its first meeting within a fortnight, will report to the Minister by 31 March 2008. The membership is as follows:

· Dr Gordon Holmes (Chair);
· Chief Superintendent John Twomey, An Garda Síochána;
· Professor Ian O'Donnell, Criminologist, University College Dublin;
· Dr Declan Bedford, Specialist in Public Health, Health Services Executive;
· Mr Seamus Carroll, Department of Justice, Equality and Law Reform, and
· Mr Robbie Breen, Department of Health and Children.


The issues of concern to be examined by the Advisory Group are:

· the increase in the number of supermarkets, convenience stores and petrol stations with off-licences and the manner and conditions of sale of alcohol products in such outlets, including below unit-cost selling and special promotions;

· the increasing number of special exemption orders which permit longer opening hours which are being obtained by licensed premises around the country; and

· the use, adequacy and effectiveness of existing sanctions and penalties, particularly those directed towards combating excessive and under-age alcohol consumption.
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Thursday, January 10, 2008

Ireland: Inquiry Into Drinking Laws

Published: January 10, 2008

Justice Minister Brian Lenihan said he would set up an advisory group to examine current laws on the sale and consumption of alcohol and report back to him by March 31. “We have a problem with binge drinking in this country, and it is clear that this problem is adding to public disorder,” he said.
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