Alcohol-related adverse consequences: cross-cultural variations in attribution process among young adults European Journal of Public HealthVolume 18, Number 4 Pp. 386-391

Social norms around what is culturally accepted in terms of alcohol consumption and drunken comportment appear important regarding the acceptance of alcohol-related adverse consequences; however, investigations often neglect to consider differences in terms of attribution.

This study aims at assessing cross-cultural differences in the reporting of alcohol-related adverse consequences. It also considers differences across consequences that might explain which type of consequences (mainly acute or mainly chronic) are most affected by an attribution process.

Differences among the patterns of associations between countries and consequences were evident. The distinction between Nordic and other European countries was persistent. A higher variability of associations was observed for some consequences, namely the mainly acute instances. Finally, the Isle of Man and Switzerland showed specific trends with associations across consequences.

Reporting of alcohol-related adverse consequences seemed strongly affected by cultural norms. The latter may be exemplified by viewing drinking as ‘time-out’ behaviour. Respondents in countries with a stereotypical history of being ‘dry’ or with a stereotyped ‘binge’ drinking culture were more likely to attribute consequences to their alcohol consumption than people in ‘wet’ countries. This was particularly true for consequences that related to episodic ‘time-out’ heavy drinking.

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Gamma-hydroxybutyric acid in male and female cynomolgus monkeys trained to discriminate 1.0 or 2.0 g/kg ethanol.
Behavioural Pharmacology. 19(4):317-324, July 2008.


Gamma-hydroxybutyric acid has been proposed as a pharmacotherapy for alcoholism in part based on similar discriminative stimulus effects as ethanol. To date, drug discrimination studies with [gamma]-hydroxybutyric acid and ethanol have exclusively used rodents or pigeons as subjects.

To evaluate possible differences between species, sex, and route of administration, this study investigated the substitution of [gamma]-hydroxybutyric acid (intragastrically or intramuscularly) for ethanol 30 or 60 min after administration in male (n=6) and female (n=7) cynomolgus monkeys trained to discriminate 1.0 and 2.0 g/kg ethanol. At least one dose of [gamma]-hydroxybutyric acid completely or partially substituted for ethanol in three of the 13 monkeys tested, with each case occurring in female monkeys.

Ethanol-appropriate responding did not increase with [gamma]-hydroxybutyric acid dose. Monkeys were more sensitive to the response rate decreasing effects of [gamma]-hydroxybutyric acid administered intramuscularly compared with intragastrically.

The lack of [gamma]-hydroxybutyric acid substitution for ethanol suggests that these drugs have different receptor bases for discrimination.

Furthermore, the data do not strongly support shared discriminative stimulus effects as the rationale for [gamma]-hydroxybutyric acid pharmacotherapy for alcoholism.


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Zolpidem Generalization and Antagonism in Male and Female Cynomolgus Monkeys Trained to Discriminate 1.0 or 2.0 g / kg Ethanol
Alcoholism: Clinical and Experimental ResearchPublished Online: 14 May 2008

The subtypes of γ-aminobutyric acid (GABA)_A receptors mediating the discriminative stimulus effects of ethanol in nonhuman primates are not completely identified. The GABA_A receptor positive modulator zolpidem has high, intermediate, and low activity at receptors containing α₁, α_2/3, and α₅ subunits, respectively, and partially generalizes from ethanol in several species. The partial inverse agonist Ro15-4513 has the greatest affinity for α_4/6-containing receptors, higher affinity for α₅- and lower, but equal, affinity for α₁- and α_2/3-, containing GABA_A receptors, and antagonizes the discriminative stimulus effects of ethanol.

Zolpidem (0.017 to 5.6 mg/kg, i.m.) completely generalized from ethanol (≥80% of total session responses on the ethanol-appropriate lever) for 6/7 monkeys trained to discriminate 2.0 g/kg and 4/10 monkeys trained to discriminate 1.0 g/kg ethanol. Zolpidem partially generalized from 1.0 or 2.0 g/kg ethanol in 6/7 remaining monkeys. Ro15-4513 (0.003 to 0.30 mg/kg, i.m., 5-minute pretreatment) shifted the zolpidem dose–response curve to the right in all monkeys showing generalization. Analysis of apparent pK_B from antagonism tests suggested that the discriminative stimulus effects of ethanol common with zolpidem are mediated by low-affinity Ro15-4513 binding sites. Main effects of sex and training dose indicated greater potency of Ro15-4513 in males and in monkeys trained to discriminate 1.0 g/kg ethanol.

Ethanol and zolpidem share similar discriminative stimulus effects most likely through GABA_A receptors that contain α₁ subunits, however, antagonism by Ro15-4513 of zolpidem generalization from the lower training dose of ethanol (1.0 g/kg) may involve additional zolpidem-sensitive GABA_A receptor subtypes (e.g., α_2/3 and α₅)

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Effects of alcohol on inhibitory processes.
Behavioural Pharmacology. 19(4):284-291, July 2008.



Earlier work has shown that alcohol may have disinhibiting effects on behaviour.

Two studies tested the effects of a moderate dose of alcohol (0.6 g/kg) versus placebo on tasks that evaluate inhibitory processes related to alcohol stimuli, in moderate-to-heavy social drinkers (student population). An inhibition of interference task, the Stroop task (ST; study 1), and an inhibition of a prepotent response task, the go/no-go task (GNG; study 2), were used. The effects of alcohol on working memory function were also examined. Participants preloaded with alcohol made more errors on the colour and alcohol ST than those preloaded with placebo.

In the GNG task, responding to alcohol-related pictures was slower than responding to neutral pictures. When participants were required to switch responding from neutral to alcohol-related go stimuli, responding became slower; however, responding to alcohol go stimuli became faster as time progressed; no effect of alcohol was found.

Alcohol had no effect, compared with placebo, on the working memory tasks. Therefore, a moderate dose of alcohol had restricted effects on inhibitory processes: only interference inhibition measured in the ST was affected.

Although the data obtained with the GNG task did not show an effect of alcohol on response inhibition, increased latency of response in the presence of alcohol-related stimuli compared with neutral stimuli indicates that alcohol stimuli are more salient to social drinkers, attracting a greater amount of attention.

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Uncovering genes for cognitive (dys)function and predisposition for alcoholism spectrum disorders: A review of human brain oscillations as effective endophenotypes
Brain Research Article in Press 24 June 2008


Brain oscillations provide a rich source of potentially useful endophenotypes (intermediate phenotypes) for psychiatric genetics, as they represent important correlates of human information processing and are associated with fundamental processes from perception to cognition.

These oscillations are highly heritable, are modulated by genes controlling neurotransmitters in the brain, and provide links to associative and integrative brain functions.

These endophenotypes represent traits that are less complex and more proximal to gene function than either diagnostic labels or traditional cognitive measures, providing a powerful strategy in searching for genes in psychiatric disorders.

These intermediate phenotypes identify both affected and unaffected members of an affected family, including offspring at risk, providing a more direct connection with underlying biological vulnerability.

Our group has utilized heritable neurophysiological features (i.e., brain oscillations) as endophenotypes, making it possible to identify susceptibility genes that may be difficult to detect with diagnosis alone.

We have discussed our findings of significant linkage and association between brain oscillations and genes in GABAergic, cholinergic and glutamatergic systems (GABRA2, CHRM2, and GRM8). We have also shown that some oscillatory indices from both resting and active cognitive states have revealed a common subset of genetic foci that are shared with the diagnosis of alcoholism and related disorders.

Implications of our findings have been discussed in the context of physiological and pharmacological studies on receptor function.

These findings underscore the utility of quantitative neurophysiological endophenotypes in the study of the genetics of brain function and the genetic diathesis underlying complex psychiatric disorders.


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Natural Course of Chronic HCV and HBV Infection and Role of Alcohol in the General Population: The Dionysos Study
Am J Gastroenterol 2008;103:1–6

Population-based studies of the natural course of chronic viral liver disease that consider comorbidity factors are lacking. Using data from the Dionysos Study, we quantified the burden of chronic viral liver disease and the role of alcohol intake to morbidity and mortality in a representative sample of subjects from the general population of two communities of Northern Italy.

We followed up 139 subjects with chronic hepatitis C virus (HCV) infection and 61 with chronic hepatitis B virus (HBV) infection for a median (IQR) time of 8.4 (1.0) and 8.3 (0.9) yr, respectively. Ethanol intake was evaluated using a food-frequency questionnaire, fatty liver (FL) was diagnosed by ultrasonography, and liver cirrhosis (LC) and hepatocarcinoma (HCC) were diagnosed by liver biopsy. Exact multivariable Poisson regression was performed to identify predictors of death.

The incidence and remission rates of FL were 9.0 and 29.7 in the HCV cohort and 4.0 and 30.4 per 1,000 person-years (PY) in the HBV cohort. Progression to LC and HCC was more common in the HCV than in the HBV cohort (4.5 vs 2.0 and 2.7 vs 2.0 per 1,000 PY, respectively).

Ethanol intake was an independent predictor of LC in the HCV cohort [rate ratio (RR) = 4.15 (95% CI 1.02–41.2) for every increase of 30 g/day of ethanol intake at baseline] and of death rate in both cohorts [RR = 8.53 (95% CI 1.40–24.61) and 3.56 (1.34 to 26.50) for every increase of 30 g/day of ethanol intake at baseline].

The morbidity and mortality rate of HBV and HCV infection in the general population is lower than that reported in secondary-care populations, blood donors, or clinical series. Ethanol intake is an independent predictor of LC in subjects with chronic HCV infection and an independent predictor of death in subjects with either HCV or HBV infection

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Ethanol’s Molecular Targets
Sci. Signal., 15 July 2008
Vol. 1, Issue 28, p. re7




Ethanol produces a wide variety of behavioral and physiological effects in the body, but exactly how it acts to produce these effects is still poorly understood.

Although ethanol was long believed to act nonspecifically through the disordering of lipids in cell membranes, proteins are at the core of most current theories of its mechanisms of action.

Although ethanol affects various biochemical processes such as neurotransmitter release, enzyme function, and ion channel kinetics, we are only beginning to understand the specific molecular sites to which ethanol molecules bind to produce these myriad effects.

For most effects of ethanol characterized thus far, it is unknown whether the protein whose function is being studied actually binds ethanol, or if alcohol is instead binding to another protein that then indirectly affects the functioning of the protein being studied.

In this Review, we describe criteria that should be considered when identifying alcohol binding sites and highlight a number of proteins for which there exists considerable molecular-level evidence for distinct ethanol binding sites.

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Watershed ban on alcohol advertising could be too costly, Government memo warns

By Harry Wallop, Consumer Affairs Correspondent

17/07/2008

Radical plans to ban all alcohol adverts on television before 9pm could be dropped amid fears the move would cripple advertising companies and broadcasters

The Department of Health and the Home Office are set to publish their long-awaited independent review into the link between alcohol prices, promotions and the harm to health caused by alcohol abuse.

One of the most popular suggestions put forward by campaigners was to strengthen the existing restrictions against drink adverts on television.

Currently, no beer, spirits or wine commercials can be aired during shows watched predominantly by children. However, various programmes very popular with youngsters, such as sitcoms and soap operas, are free from these restrictions because adults make up the majority of the audience.

A blanket pre-9pm ban has been ruled out by officials in the Department for Culture, Media and Sport, it is understood.

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Gene found that limits alcohol risk

• Denis Campbell, health correspondent
• The Observer,
• Sunday July 20, 2008

British researchers discover genetic make-up of one in four could reduce dangers of drinking

As many as one in four Britons have a much-reduced risk of developing alcohol-related cancer thanks to their genetic make-up, scientists have discovered. Researchers have identified two genes that quickly flush alcohol out of the system, thus reducing its carcinogenic effect. People carrying one or both of the genes may have only half the chance of developing mouth, throat and oesophageal cancers that are strongly associated with drinking.

The genes involved are rare versions of ADH7 and ADH1B. The ADH range of genes help the body to process alcohol. Everyone carries two versions of each of these genes, one inherited from each parent, but only 15 to 20 per cent of the UK population have ADH7, while around another 5 per cent have ADH1B.

A study of 9,000 people has shown for the first time that people carrying one or both of these rare gene variants have a much lower risk of getting head or neck cancer than those who have the common versions. For example, those with ADH1B have only half the chance of developing such cancers and people with ADH7 are at a 32 per cent reduced risk.

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The genomic determinants of alcohol preference in mice
Mammalian Genome Online First 19 June 2008


Searches for the identity of genes that influence the levels of alcohol consumption by humans and other animals have often been driven by presupposition of the importance of particular gene products in determining positively or negatively reinforcing effects of ethanol.

We have taken an unbiased approach and performed a meta-analysis across three types of mouse populations to correlate brain gene expression with levels of alcohol intake. Our studies, using filtering procedures based on QTL analysis, produced a list of eight candidate genes with highly heritable expression, which could explain a significant amount of the variance in alcohol preference in mice.

Using the Allen Brain Atlas for gene expression, we noted that the candidate genes’ expression was localized to the olfactory and limbic areas as well as to the orbitofrontal cortex. Informatics techniques and pathway analysis illustrated the role of the candidate genes in neuronal migration, differentiation, and synaptic remodeling.

The importance of olfactory cues, learning and memory formation (Pavlovian conditioning), and cortical executive function, for regulating alcohol intake by animals (including humans), is discussed.

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Statistics on Discharges From Substance Abuse Treatment Services for 2005

The Substance Abuse and Mental Health Services Administration (SAMHSA) is issuing its latest Treatment Episode Data Set (TEDS) report on Discharges from Substance Treatment Services which provides a myriad of information on substance abuse treatment episodes at state licensed treatment facilities across the country.

The 2005 TEDS Discharges from Substance Treatment Services report is the latest in a series of yearly reports that not only provide overall figures for the 34 states that report discharge data to TEDS, but also break this information down into a wide variety of programmatic and demographic criteria that can help provide greater perspective on the experiences of those who have undergone substance abuse treatment.

Among the notable findings in this latest report:

			The treatment completion rate was highest among clients discharged from hospital residential treatment (67 percent), detoxification (65 percent) and short-term residential treatment (56%). Treatment completion rates were lower in longer term and less-structured settings.
			Not counting discharges receiving opioid replacement therapy (methadone), the median length of stay in treatment was greatest for discharges from outpatient treatment (76 days), followed by long-term residential treatment (53 days) and intensive outpatient treatment (46 days).
			The strongest predictor of treatment completion was the use of alcohol rather than other drugs. Clients discharged from all types of service combined were 82 percent more likely to complete treatment or transfer to further treatment if their primary substance was alcohol, after taking into account all other characteristics. Read Contents _______________________________________________________________________________________

Incorporating the Family as a Critical Context in Genetic Studies of Children: Implications for Understanding Pathways to Risky Behavior and Substance Use
Journal of Pediatric Psychology Advance Access published online on June 12, 2008


The availability of candidate gene markers for biobehavioral traits will undoubtedly result in increasing attention to genetic influences in studies of childhood risk factors for health behaviors. However, a strict emphasis on genomics without consideration of the social contexts that give rise to risky behaviors will miss opportunities to understand more fully the powerful effect of the family on childhood development.

This article discusses the rationale for using the family as a critical context for studying the translation of genetic propensity for risky behavior into developmental pathways that span childhood and adolescence.

Attention is given to the importance of family environmental factors; the emerging literature on genetic influences on potential intermediate phenotypes; the need for rich and detailed characterizations of both phenotypes and environmental risk factors embedded within genomic studies of children; and implications for interventions and preventions aimed at risky behaviors.

Via discussion of these issues, pragmatic considerations of how studying families as a context may facilitate the thoughtful inclusion of children into genetic paradigms are emphasized.

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SABMiller launches TalkingAlcohol.com

SABMiller has launched TalkingAlcohol.com – a comprehensive guide to alcohol from how beer is made to the health and social considerations about alcohol.

Visit TalkingAlcohol.com
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KENTUCKY SUBSTANCE ABUSE TREATMENT OUTCOME STUDY
FY 2006 FOLLOW-UP FINDINGS


This report summarizes fiscal year 2006 KTOS findings regarding the outcomes of substance abuse treatment in Kentucky. Unlike most studies of treatment effectiveness, the KTOS study examines the outcomes of treatment as it is provided in community practice. That is, the treatment providers are not instructed to use a specific intervention or clinical approach and the services include a wide array of outpatient, intensive outpatient and residential types.

Data are collected at intake and a sample of former clients was interviewed by research staff at CDAR 12 months after the intake interviews. This report includes follow-up data on a sample of 906 substance abuse treatment clients in Kentucky who consented to participate and who had been in treatment between July 2005 and June 2006. There was a follow-up rate of 65.3%.
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Executive Summary
Section One
Section Two
Section Three
Section Four
Section Five & Six
Appendices


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French Combat Youth Binge-Drinking

By BRUCE CRUMLEY / PARIS


Thursday, July 17, 2008

In decrying the excessive alcohol consumption of their compatriots, American and British health experts have long pointed to France with special admiration. Here, they said, was a society that masters moderate drinking. In wine-sipping France, the argument went, libation is just a small part of the broad festival of life, not the mind-altering prerequisite for a good time. The French don't wink like the English do at double-fisted drinking; they scorn people who lose control and get drunk in public. It's a neat argument. But it sounds a little Pollyannish now that France itself is grappling with widespread binge-drinking among its youth.
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Mental disorders and mental health care in Canada and Australia: comparative epidemiological findings

Social Psychiatry and Psychiatric Epidemiology Online Fist 15 July 2008


Canada and Australia although geographically distant have similarities in human geography and history. Each has had a national mental health policy for some years, but Australia has driven policy implementation in this area harder than has Canada.

Comparable epidemiological surveys from Australia in 1997 and Canada in 2002 allow us to explore relative rates of mental disorders and compare estimates of access to care from mental health services.

Differences in prevalence rates and in service utilisation emerge between the two countries: Anxiety Disorders are estimated as almost 2% higher in Canada than in Australia while there is suggestion that Major Depressive Disorder, Alcohol Dependence and Drug Dependence may be more prevalent in Australia. More of the people with co-morbid disorders in Australia than in Canada make use of mental health services and a finding of marginal significance suggests that this may be true across all disorders.

Causation cannot be determined from this study but possible explanations for differences in prevalence include changes in global economic, political and security contexts and concerns between 1997 and 2002 and the possible role of greater availability of alcohol in Australia. The findings also provide encouragement that strenuously implementing a national mental health policy may have been of benefit to people with mental health problems in Australia.

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Drug Use, Smoking and Drinking among young people in England 2007


This survey is the latest in a series designed to monitor smoking, drinking and drug use among secondary school pupils aged 11 to 15. Information was obtained from 7,831 pupils in 273 schools throughout England in the autumn term of 2007.

Drinking alcohol

The proportion of 11 to 15 year olds who have never drunk alcohol has risen in recent years, from 39% in 2003 to 46% in 2007. More than half of pupils aged between 11 and 15 have had at least one alcoholic drink in their lifetimes. This increases with age from 20% of 11 year olds to 81% of 15 year olds.

There has been a corresponding decline in the proportion of pupils who have drunk alcohol in the last seven days. In 2007, one in five (20%) of pupils said they had drunk alcohol in the last week; this is similar for boys and girls. The proportion who have drunk in the last week increases with age from 3% of 11 year olds to 41% of 15 year olds. White pupils are more likely to have drunk alcohol recently than those from minority ethnic groups.

Since 2000, average consumption among pupils who did drink has varied from year to year with no clear pattern. In 2007, average consumption was lower than in 2006.

The method of calculating pupils’ alcohol consumption in units has been revised this year in line with other surveys. Using the revised method of calculating consumption, pupils who drank alcohol in the last week consumed an average of 12.7 units, equivalent to over six pints of normal strength beer or nearly one and a half bottles of wine. Boys tend to drink more than girls and older pupils than younger ones.

Recent drinking is associated with other risky behaviours. Smokers and pupils who have taken drugs have increased odds of having drunk alcohol within the last week. Pupils who have a history of truancy or exclusion from school are also more likely to have drunk alcohol in the last seven days.

The report includes further information about the frequency of pupils’ drinking, and types of alcohol drunk.

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New tax reform to cut alcohol prices - except for whiskey

By STEPHANIE RUBENSTEIN AND GREER FAY CASHMAN

July 16, 2008

Although Israel's exorbitant taxation on whiskey has upset even British Ambassador Tom Phillips, taxes on other alcoholic beverages are expected to be reduced soon, The Jerusalem Post has learned.

In a new reform due to be adopted in a few months, all brands of alcohol will have the same tax per liter, instead of higher taxes only for luxury brands, according to Dan Leeor, managing director of the Scottish Trading Company, which imports wine and spirits.

The tax reform will take place over the course of three years, and prices will be reduced each year. After three years, the tax on alcoholic beverages will be NIS 37 per one liter of pure alcohol, according to Leeor. For example, an 80-proof bottle of vodka (which means it is 40 percent alcohol) would be taxed 40% of the NIS 37.

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Press Release - NCL Challenges Myth that Some Alcoholic Beverages Are 'Safer' and 'Less Potent' July 16, 2008 New Initiative Underscores Need for New Alcohol Label Washington, DC – For the many Americans confused about the potency of different alcoholic beverages, one of the most respected national consumer organizations has this important message: it is a myth that beer and wine are not as strong as the typical cocktail. Standard serving sizes of all alcohol beverages -- beer, wine, and distilled spirits -- are equal in alcohol strength and their effect on the body. Because even the most basic information about alcohol content is not clearly and consistently listed on the labels of beer, wine and distilled spirits products, the National Consumers League is going public with Alcohol: How It All Adds Up, a new initiative challenging the myth that some alcoholic beverages are “safer” and less “potent” than others. According to the League, this belief is pervasive and linked with the overconsumption of alcohol and the permissive attitudes of some parents about underage drinking. In an opinion poll commissioned by the Center for Government Reform, 88% of parents mistakenly concluded that beer is safer than liquor. . . . . . . Read Full Press Release _________________________________________________________________________________________

Psychosocial Antecedents and Adverse Health Consequences Related to Substance Use
AJPH First Look, published online ahead of print Jul 16, 2008



We examined the relationship between psychosocial antecedents in earlier adolescence and problems of substance use and related adverse health consequence (e.g., respiratory diseases, cardiovascular diseases, and cancer) in adulthood. We specifically focused on parent–child bonding in earlier adolescence and internalizing behaviors in later adolescence and how they relate to problems related to substance use in the mid-20s and health problems in the mid-30s.

Our team interviewed a community-based sample of 502 participants over a 30-year period (1975, 1983, 1985–1986, 1997, 2002, and 2005).

We found a strong relationship between internalizing behaviors in later adolescence and adverse health consequences in the mid-30s. Internalizing behaviors in later adolescence served as a mediator between low parent–child bonding in earlier adolescence and later adverse health consequences.

Problems related to substance use in the late 20s and early 30s were related directly to later adverse health consequences and indirectly as mediators between earlier psychosocial difficulties (i.e., internalizing behaviors, externalizing behaviors, poor ego integration, and maladaptive coping) and later adverse health consequences.

Policies and programs that address parent–child bonding and internalizing behaviors should be created to reduce problems related to substance use and, ultimately, later health problems.

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