Peer influence in a micro-perspective: Imitation of alcoholic and non-alcoholic beverages

Ample experimental research has found evidence for imitation of alcohol consumption in social encounters. However, these studies cannot reveal whether imitation is specifically related to alcohol and not to consumption in general.

We investigated whether imitation is more evident when peers drink alcohol compared to other beverages. We observed sipping behavior during a 30-minute interaction between same-sex confederates and participants in an ad lib semi-naturalistic drinking context (bar lab). We expected a stronger imitation effect when both participant and confederate drank alcoholic beverages. A random occasion multilevel analysis was conducted to take repeated measurements into account.

Findings showed that participants imitated the sips of the confederates, but that the likelihood of participants imitating a sip was lower when confederates were drinking alcoholic beverages and participants non-alcoholic beverages compared to when both were consuming alcohol.

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Request Reprint E-Mail: H.Larsen@pwo.ru.nl


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A Psychometric Validation of the Short Alcohol Withdrawal Scale (SAWS)

The study aimed to evaluate psychometrically a Danish translation of the Short Alcohol Withdrawal Scale (SAWS) in an outpatient setting in patients with Alcohol Dependence (AD) and Alcohol Withdrawal Symptoms/Syndrome (AWS).

One hundred and twenty-two patients with AD and AWS filled in a 10-item rating scale to describe their symptoms with four graduations on five physical and five psychological items.

The question of dimensionality of the construct was addressed in three different ways. First, a scree plot was constructed based on the polychoric correlations between items. Second, promax factor loadings were calculated for a two-factor model. These two steps were based on exploratory factor analysis. Third, specific violations such as local dependence and differential item functioning were investigated under the one-factor model in a confirmatory factor analysis.

The scree plot supported one or two dimensions while the promax rotations gave little support for a two-factor model. The confirmatory analysis also supported a one-factor model.

The decomposition of the polychoric correlation matrix into eigenvalues and vectors suggested that there was most likely one factor underlying the 10 items in the SAWS. This was confirmed by a confirmative factor analysis with only one component when specific model violations such as local dependence and differential item findings were investigated. The SAWS is easy to use.



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Request Reprint E-Mail: becker@dadlnet.dk


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Rates of fetal alcohol exposure among newborns in a high-risk obstetric unit

Meconium fatty acid ethyl esters (FAEEs) are sensitive and specific biomarkers for prenatal alcohol exposure (PAE) in pregnancy. We recently reported a 2.5% rate of FAEE positive meconium in a general population sample of infants born in the region of Grey-Bruce, Ontario. Women in this region with high-risk pregnancies are transferred to a tertiary care facility in London, Ontario.

The objective of this study was to determine, in a population-based sample, whether high-risk pregnancies are associated with an increased risk of in utero alcohol exposure.

Grey-Bruce residents transferred to the high-risk obstetric unit of St. Joseph's Health Care in London, Ontario were identified and consented to this anonymous prevalence study. Meconium was collected and analyzed for FAEE using gas chromatography with mass spectrometry. The prevalence of FAEE positive meconium was compared with the population-based prevalence in the Grey-Bruce. Fifty meconium specimens were collected from August 1, 2006 to July 31, 2007. Fifteen (30%) specimens tested positive for FAEE.

The results indicate that infants born in the high-risk obstetric unit had a 12-fold higher risk of screening positive for second and third trimester alcohol exposure compared with infants born in the general population of Grey-Bruce (relative risk=12.04, 95% confidence interval=6.40–22.65, P.0001).

These results suggest that the high-risk pregnancies should be screened for PAE and followed-up for potential diagnosis of fetal alcohol spectrum disorder.

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Request Reprint E-Mail: gkoren@sickkids.ca

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Correlation between drugs of abuse and alcohol by hair analysis: parents at risk for having children with fetal alcohol spectrum disorder

The fatty acid ethyl esters (FAEEs) hair test, a biomarker of excessive alcohol exposure, has demonstrated its potential for use in fetal alcohol spectrum disorder (FASD) diagnosis. FASD may be compounded by polydrug exposure.

Our objective was to determine the likelihood of positive FAEE test among parents testing positive for other drugs of abuse.

Samples submitted for FAEE hair analysis by Children's Aid Societies between October 2005 and May 2007, also concurrently tested for cocaine, cannabinoids, opiates, methamphetamine, amphetamine, benzodiazepines, methadone, and/or oxycodone, were included in our analysis. Subjects consisted of parents suspected of using excessive amounts of alcohol.

Parents testing positive for drugs of abuse had a significantly increased risk for testing positive for high FAEE. Mothers testing positive for heavy chronic alcohol use were found to have a threefold increased risk of testing positive for cocaine (odds ratio=3.26, 1.1–9.7).

Our results suggest that parents abusing stimulants are at risk of high alcohol exposure, which put their unborn children at risk for FASD.

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Request Reprint E-Mail: gkoren@sickkids.ca

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Fetal brain during a binge drinking episode: a dynamic susceptibility contrast MRI fetal brain perfusion study

We assessed the effects of a single episode of maternal alcohol intoxication on fetal brain blood perfusion in three pregnant dams (baboons) at the 24th week of pregnancy using dynamic susceptibility contrast magnetic resonance imaging.

After the oral administration of alcohol, there was a four-fold increase in the peak contrast concentrations in the fetal brain. In addition, we observed a two- to three-fold increase in the contrast uptake and washout rates in the fetal brain.

The underlying mechanisms of these changes are unknown, but we hypothesized that these could include the alcohol-mediated changes in placental permeability and fetal cerebral blood flow.

Our findings indicate that alcohol intoxication produces profound changes, which may detrimentally influence neurodevelopmental processes in the brain.

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Request Reprint E-Mail: kochunov@uthscsa.edu

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Finnish women drinking six times more than they did 40 years ago

Consumption of alcohol by women has increased nearly sixfold in the past 40 years. Researchers see the changes in women’s drinking habits to be one of the most significant individual changes in Finnish drinking culture in recent decades. . > > > > Read More



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"What's NOT on the bottle?" - Eurocare response to vote of the EP on ‘Food Information to Consumers’

Eurocare (European Alcohol Policy Alliance) is extremely disappointed with the shape of the Food Information to Consumers legislation which exempts alcoholic beverages from obligation to list its content. This is despite the fact that alcohol is high in calorie content, carbohydrates and certain ingredients used in its production can cause allergies or intolerances.

We strongly believe that we all have the right to make informed choices and the current proposal will mean that one will know what is in a bottle of a fruit juice but not in a bottle of alcoholic beverage.

Providing information (about ingredients, energy value, units or total grams of pure alcohol per 100ml) would allow consumers to assess the quality of the beverages and keep track of their calorie and alcohol intake.

An overwhelming majority of Europeans wants to be informed about consequences of drinking; 79% supports warning health messages on bottles and 82% are in favour of such warnings on advertisements (Eurobarometer 2009). > > > > Read More

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Bottoms up for new Kenya alcohol law

The National Campaign Against Drug Abuse Authority (NACADA) has applauded the Alcoholic Drinks Control Bill, 2009 which legalises illicit brews but gives strict regulations under which they should be prepared and distributed.

The Bill which will also tax traditional brews seeks to ensure that the government controls all alcoholic drinks in the Kenyan market as well as monitor its contents.

> > > > Read More


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Ethanol Enhances Taurine-Activated Glycine Receptor Function

Emerging evidence suggests that taurine acts as a partial agonist on glycine receptors (GlyR) in vitro and in vivo. Ethanol acts as an allosteric modulator on the GlyR producing a leftward shift of the glycine concentration–response curve, with no enhancing effects observed at saturating glycine concentrations. However, to date, no electrophysiological studies have been performed on ethanol modulation of taurine-activated GlyR.

Wild-type α1 GlyR, or those bearing a serine-267 to isoleucine replacement (S267I), were homomerically expressed in Xenopus oocytes and voltage clamped at −70 mV. Ethanol was co-applied with varying concentrations of glycine or taurine and the enhancing effects of ethanol compared.

Ethanol potentiated glycine- and taurine-activated GlyR responses in a concentration-dependent manner. It shifted taurine and glycine concentration–response curves to the left, having no effects at saturating agonist concentrations. Chelation of zinc by tricine decreased ethanol enhancement of taurine-gated GlyR function. The S267I mutation prevented ethanol enhancement of taurine-mediated responses as previously also reported for glycine.

Ethanol modulates taurine activation of GlyR function by a mechanism similar to that of the full agonist glycine. The lack of effect of ethanol at saturating taurine concentrations provides mechanistic information on alcohol actions at the GlyR.

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Request Reprint E-Mail: mihic@mail.utexas.edu

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Defective Translocation of PKCε in EtOH-Induced Inhibition of Mg2+ Accumulation in Rat Hepatocytes

Rats chronically fed ethanol for 3 weeks presented a marked decreased in total hepatic Mg²⁺ content and required approximately 12 days to restore Mg²⁺ homeostasis upon ethanol withdrawal. This study was aimed at investigating the mechanisms responsible for the EtOH-induced delay.

Hepatocytes from rats fed ethanol for 3 weeks (Lieber-De Carli diet—chronic model), rats re-fed a control diet for varying periods of time following ethanol withdrawal, and age-matched control rats fed a liquid or a pellet diet were used. As acute models, hepatocytes from control animals or HepG2 cells were exposed to varying doses of ethanol in vitro for 8 minutes.

Hepatocytes from ethanol-fed rats presented a marked inhibition of Mg²⁺ accumulation and a defective translocation of PKCε to the cell membrane. Upon ethanol withdrawal, 12 days were necessary for PKCε translocation and Mg²⁺ accumulation to return to normal levels. Exposure of control hepatocytes or HepG2 cells to a dose of ethanol as low as 0.01% for 8 minutes was already sufficient to inhibit Mg²⁺ accumulation and PKCε translocation for more than 60 minutes. Also in this model, recovery of Mg²⁺ accumulation was associated with restoration of PKCε translocation. The use of specific antisense in HepG2 cells confirmed the involvement of PKCε in modulating Mg²⁺ accumulation.

Translocation of PKCε isoform to the hepatocyte membrane is essential for Mg²⁺ accumulation to occur. Both acute and chronic ethanol administrations inhibit Mg²⁺ accumulation by specifically altering PKCε translocation to the cell membrane.

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Request Reprint E-Mail: amr5@po.cwru.edu

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Laboratory Models Available to Study Alcohol-Induced Organ Damage and Immune Variations: Choosing the Appropriate Model

The morbidity and mortality resulting from alcohol-related diseases globally impose a substantive cost to society.

To minimize the financial burden on society and improve the quality of life for individuals suffering from the ill effects of alcohol abuse, substantial research in the alcohol field is focused on understanding the mechanisms by which alcohol-related diseases develop and progress. Since ethical concerns and inherent difficulties limit the amount of alcohol abuse research that can be performed in humans, most studies are performed in laboratory animals.

This article summarizes the various laboratory models of alcohol abuse that are currently available and are used to study the mechanisms by which alcohol abuse induces organ damage and immune defects. The strengths and weaknesses of each of the models are discussed.

Integrated into the review are the presentations that were made in the symposium "Methods of Ethanol Application in Alcohol Model—How Long is Long Enough" at the joint 2008 Research Society on Alcoholism (RSA) and International Society for Biomedical Research on Alcoholism (ISBRA) meeting, Washington, DC, emphasizing the importance not only of selecting the most appropriate laboratory alcohol model to address the specific goals of a project but also of ensuring that the findings can be extrapolated to alcohol-induced diseases in humans.


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Request Reprint E-Mail: nbdsou0@uky.edu


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The Effect of Aripiprazole on Cue-Induced Brain Activation and Drinking Parameters in Alcoholics

Because the effects of alcohol and its environmental cues on brain dopamine have been implicated in the maintenance of heavy drinking, drugs that modify dopamine might be useful in reducing drinking or promoting abstinence.

The goal of the current study was to use an established brain imaging paradigm to explore the effect of aripiprazole (final dose 15 mg over a 14-day period), a dopamine stabilizer medication, on alcohol cue-induced brain activation and drinking in alcoholics.

Non-treatment-seeking alcoholics were randomly assigned aripiprazole (n = 14) or identical placebo (n = 16) and reported their alcohol use while taking study medication for 14 days before an alcohol cue-induced brain functional magnetic resonance imaging study.

In a Philips 3.0-T magnetic resonance imaging scanner, subjects were given a sip of alcohol before viewing a randomized presentation alcoholic- and nonalcoholic-beverage photographs while subjects rated their urge to drink. During photograph presentation, changes in regional brain activity were measured, and differences between viewing alcoholic beverage and nonalcoholic beverages were compared within and between groups.

Brain activity analysis revealed increased activation for placebo-treated subjects in the right ventral striatum (P < 0.005; threshold 15 voxels), while there was a blunting of activation in this area in the aripiprazole-treated subjects. Aripiprazole-treated subjects, compared with placebo-treated subjects, also had significantly less heavy drinking during the 14-day medication period.

The study provides both novel and valuable information regarding the effect of aripiprazole on cue-induced brain activation and voluntary drinking during treatment.


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Request Reprint E-Mail: myrickh@musc.edu


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Alcohol as evil – Temperance and policy

Beverage alcohol has developed indelibly different footprints in different cultures.

-Research shows, indeed, that how a culture views and appreciates alcohol impacts people's very likelihood of being addicted to it. In this context, the US and other Protestant English-speaking nations, and particularly Nordic ones, are characterized by intense binge drinking – amidst overall low consumption – leading to both social and health problems (including higher levels of alcohol-related mortality).

At the same time, these are the very nations that propose alcohol control policies worldwide, which they support with advanced epidemiologic research.

Ironically, this same research has shown how peculiar Temperance cultures’ drinking patterns are, particularly in contrast with those in Southern Europe. Yet superior-drinking cultures are ignored – even belittled – in formulating governmental alcohol policies.

This paradox is explored and laid at the feet of ingrained anti-alcohol feelings that pervade Temperance cultures.

One resulting subplot is the effort by leading Temperance journals and researchers to discourage alcohol producers and sellers from having any role in policy, and to punish and to ban researchers and social scientists in any way associated with producers and sellers.

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Request Reprint E-Mail: stanton@peele.net

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ICAP Periodic Review on Drinking and Culture

Issue 4 • May/June 2010

This Review issue features summaries of recent journal articles, reports, and books from 9 central, eastern, and southern European countries, covering the following topics: alcohol and the workplace, drinking and violence, drinking patterns in adult population, early identification and brief intervention, extreme/”binge” drinking, motivations and expectancies, road safety, and young people.

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Affective and Personality Risk and Cognitive Mediators of Initial Adolescent Alcohol Use

This study examined the role of cognitive factors--such as expectancies regarding the consequences of not drinking and perceptions of peer drinking--in mediating affective and personality-based risk associated with adolescents' decisions to initiate alcohol use.

Nondrinking high school students (N = 1,268) completed confidential surveys on adolescent attitudes and behaviors related to substance use in 2 consecutive years. Self-reported alcohol use was assessed in both years, and social anxiety, depression, sensation seeking, expectancies for not drinking, and perceived peer alcohol use were assessed in the second year.

The odds of initiation were considerably lower for students with higher expectancies for not drinking, compared with those with lower expectancies. Odds of initiation rose significantly with each additional perceived peer drink reported. Both cognitive factors mediated the relationships between social anxiety, depression, sensation seeking, and alcohol-use initiation. Beliefs regarding the consequences of not drinking and perceived peer drinking play key roles in the relationship between affective and personality styles on adolescent drinking. These cognitive differences may explain varying affective risk profiles for alcohol initiation and use during adolescence, and they can provide tools for prevention efforts.


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Request Reprint E-Mail: sanbrown@ucsd.edu



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Generational patterns of alcohol consumption: Continuity and change

In most contemporary western societies there is growing concern about rising levels of alcohol consumption, particularly by young people, even in countries, such as France, which have previously been assumed to have ‘sensible’ drinking cultures.

Recent popular and policy debates about British drinking cultures have hinted at a shift in generational attitudes towards alcohol, as well as patterns of consumption.

Previous intergenerational studies of work and care have found that in particular historical periods different normativities develop, reflecting both social and economic conditions.

In this paper, we draw on a research project about alcohol consumption conducted in an urban and rural area – including intergenerational interviews with case study families – to identify the different normativities in terms of attitudes towards and consumption of alcohol experienced by three cohort generations in their youth.

The paper then goes on to explore the patterns of both change and continuity that are evident in the interviewees' experiences.

The conclusion reflects on drivers of intergenerational change and associated health policy implications.

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Request Reprint E-Mail: g.valentine@leeds.ac.uk

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Alcohol Screening and Brief Intervention A guide for public health practitioners

The purpose of this manual is to provide public health professionals, such as health educators and community health workers, with the information, skills, and tools needed to conduct SBI so that they can help at-risk drinkers reduce their alcohol use to a safe amount or stop drinking. Using this effective intervention to reduce risky drinking can help improve the health of individuals and communities by preventing the range of negative outcomes associated with excessive alcohol use: injuries and deaths, including from motor vehicle crashes; social problems, such as violence; physical and mental illnesses; and employment, relationship, and financial problems.

This manual provides background information and practical steps for conducting SBI in a variety of public health settings, including trauma centers, emergency departments, other clinical settings, home visits, and public events. The manual provides brief descriptions of the problems associated with alcohol misuse, types of alcohol use, value of a public health approach in addressing alcohol problems, history and effectiveness of SBI, and key issues in screening and brief intervention. Guidance is given on choosing a screening tool and conducting screening. The four main steps in conducting brief interventions are described, including the purpose of each step, what to do, and suggestions for what to say. Also included is information on the most commonly used screening tools, a handout for clients, and a list of additional resources.


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Budget cuts will affect death rate, says report

The spending cuts made by the chancellor, George Osborne, in this week's budget could cause up to 38,000 extra deaths over the next decade, according to academic research published tomorrow.

Reductions in welfare payments and the 25% cut in spending across many government departments could lead to an increase in heart attacks and alcohol-related illnesses, according to analysis produced exclusively for the Guardian by an epidemiologist at Oxford University.

David Stuckler warns that the announced reduction in overall support for the long-term unemployed, disabled people and families and children, might severely impact people's health, or even cost them their lives.

> > > > Read More

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Budget crises, health, and social welfare programmes

The recession of 2008 has had profound economic consequences for many countries. How and when to reduce budget deficits was a major focus in the recent general election in the United Kingdom and continues to make headlines around the world. The new government has already begun to make large cuts in public expenditure,^{1 2} even though the UK’s projected underlying debt, as a share of gross domestic product (GDP), is less than that of other industrialised countries, it has longer than many other countries before it is required to refinance loans (table 1), and the actual deficit in 2009-10 was considerably less than expected. Leading economists have widely divergent views about whether the cuts will aid or hinder economic recovery,^{3 4} but have paid scant attention to the potential effects of reductions in health and social expenditure on population health.⁵ We examine historical data for insights into how lower levels of public spending might affect health.

> > > > Read Full Article

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Family Member Involvement in Relapse Prevention Improves Alcohol Dependence Outcomes: A Prospective Study at an Addiction Treatment Facility in India

The aims of this study were to test if outcomes would be different when family members of alcohol-dependent individuals were included in intervention and to examine the factors associated with relapse during a 6-month follow-up period.

Ninety male participants admitted for 3 weeks at an inpatient facility in India were randomly assigned to individual relapse prevention (IRP), dyadic relapse prevention (DRP), and treatment as usual (TAU), with 30 participants in each group. In IRP, intervention was administered to the individual participant. In DRP, both the participant and a family member were included in intervention. In all three conditions, family members stayed in the facility with participants. Participants were followed up for 6 months after discharge from the treatment center.

DRP consistently performed better than TAU on all of the outcomes (reduction in quantity of alcohol, drinking days, and number of days with dysfunction in family, occupational, and financial dimensions). DRP participants also reported a significant reduction in the quantity of alcohol, drinking days, and family problems, compared with IRP.

Results of Cox regression showed that being in IRP/TAU groups, early-onset dependence (<25 years), and paternal history of alcohol dependence were associated with relapse after adjusting for baseline alcohol use and other covariates.

Findings provide evidence for the effectiveness of Western-based family-oriented intervention for alcohol-dependent patients in India; also, findings might help to alert treatment providers that some subsets of alcohol users might need more tailored interventions and rigorous monitoring during follow-up.


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Request Reprint E-Mail: prasanthin@epi.wustl.edu


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