ALCOHOL REPORTS

Monday, April 11, 2011

Are mental health and binge drinking associated in Dutch adolescents? Cross-sectional public health study.

Depression and anxiety disorders have a high disease burden and as many as 15% of young people report mental health problems. Binge drinking, which is a particularly harmful way of consuming alcohol, is common among secondary school students.

The aim of this study was to examine the association between binge drinking and self-reported mental health in boys and girls aged 12 to 18 years.

This cross-sectional analysis was performed on data collected by the Community Health Service (GGD) Brabant Zuidoost, the Netherlands, in 2007. In this Youth Survey, 10 090 randomly selected adolescents aged 12 tot 18 years were each sent a letter, a questionnaire, and a user name and log-in code for if they preferred to complete the Internet version of the questionnaire. Mental health was assessed using the Mental Health Inventory (MHI-5), a short 5-item questionnaire to detect feelings of depression and anxiety. Participants were asked about current alcohol consumption, their relationship with their parents, drug use, and sociodemographic data. Corrected for confounders, binge drinking and mental health problems were associated in the 12 to 15 year old girls (OR 2.43; 95% CI 1.86-3.17, p=0.000) and boys (OR 1.64, 95% CI 1.19-2.27, p=0.003). The majority of the 16 to 18 year old adolescents had been binge drinking in the previous 4 weeks (69.6% boys and 56.8% girls). In this age group, boys with mental health problems were less likely to be classified as binge drinkers than were boys without mental health problems (OR 0.63, 95% CI 0.45-0.87, p=0.005). No such association between binge drinking and mental health was found in girls of this age.

Girls and boys aged 12-15 years were classified as binge drinkers significantly more often when they reported poor mental health. Because binge drinking damages the brain, especially at a young age, it is important that health professionals are alert to possible binge drinking when young adolescents report mental health problems and should ask their patients about their drinking behaviour. Likewise, if youngsters under 16 present with binge drinking, they should be asked whether they are anxious or depressed.

Read Full Article (PDF)

News Release - New Warm Line Helps Clinicians Tackle Patients' Substance Abuse

A free, nationwide service was launched today to help primary care providers seeking to identify and advise substance-abusing patients. The service, Physician Clinical Support System for Primary Care (PCSS-P), offers peer-to-peer mentorship and resources on incorporating screening and follow-up into regular patient care. PCSS-P is a project of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and the American Society of Addiction Medicine (ASAM. > > > > Read More

The relationship between services delivered and substance use outcomes in New Mexico's Screening, Brief Intervention, Referral and Treatment (SBIRT) Initiative

Recent years have seen increased diffusion of Screening, Brief Intervention, Referral and Treatment (SBIRT) in healthcare environments. This study examined the relationship

between substance use outcomes and service variables within the SBIRT model.

Over 55,000 adult patients were screened for substance misuse at rural health clinics throughout New Mexico during the SBIRT Initiative. This naturalistic pre–post services study used administrative baseline, 6 month follow-up, and services data for adult participants in the New Mexico SBIRT evaluation (n = 1208). Changes in self-reported frequency of illicit drug use, alcohol use, and alcohol intoxication were examined as a function of service level (brief intervention – BI vs. brief treatment/referral – BT/RT) and number of service sessions.

Participants reported decreased frequency of illicit drug use, alcohol use, and alcohol intoxication 6 months after receipt of SBIRT services (p < .001 for each). Compared to those who received BI, participants who received BT/RT had sharper reductions in frequency of drinking (IRR = .78; p < .05) and alcohol intoxication (IRR = .75; p < .05). Number of service sessions was associated with reduced frequency of alcohol use (IRR = .84; p < .01) and intoxication (IRR = .82; p < .05), but only among those who received BI.

Substance-using patients with disparate levels of use may benefit from SBIRT. In a real-world, multi-site rural SBIRT program, services of higher intensity and (within the BI modality) frequency were associated with greater magnitude of change in drinking behaviors. Reductions in illicit drug use, while substantial, did not differ significantly based on service variables. Future studies should identify the preferred service mix in the SBIRT model as it continues to expand.

Read Full Abstract

Request Reprint E-Mail: jgryczynski@friendsresearch.org

Childhood physical punishment and the onset of drinking problems: Evidence from metropolitan China

Evidence in support of a suspected causal association linking childhood physical punishment (CPP) and later alcoholic beverage-related disturbances has been found in metropolitan China.

Here, the focus shifts to the CPP association with the estimated risk of starting to drink, having the first drinking problem, and transitioning from first drink to the first drinking problem.

Data are from the World Mental Health Surveys-metropolitan China study, with representative samples of adult household residents living in two metropolitan cities, Beijing and Shanghai. Recalled information was available for early life experiences (including CPP, other childhood adversities, and parental alcohol and drug problems), as well as the onset age of drinking and drinking problems. Survival analyses were used to estimate the Hazard Ratio. A structural equation modeling approach was used to control for other inter-correlated childhood adversities.

Cox proportional hazards modeling discloses statistically robust associations linking CPP with drinking and drinking problems, as well as more rapid transitions from first drink to first drinking problem, even after accounting for other childhood adversities and parental drinking problems. These associations cannot be attributed to a more general noxious family environment.

These results lay a foundation for future experimental studies on the possible causal relationship linking CPP with the onset of drinking problems and the transition from drinking to drinking problems.

Read Full Abstract

Request Reprint E-Mail: dengy@mail.tsinghua.edu.cn

Alcohol News 15/2011

BMJ (EU) - Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. These data support current political efforts to reduce or to abstain from alcohol consumption to reduce the incidence of cancer.

The Local (Sweden) - Most Swedes sober when losing their virginity: study

Three out of four Swedes are sober when they have sex for the first time, a new study shows. The findings come from a comprehensive study on the sexual habits of Swedes aged 15 to 29 and carried out by researchers at the University of Gothenburg.

ERR News (Estonia) - Scientists Discover Gene Influencing Alcohol Consumption

Scientists have discovered that those possessing the gene AUTS2 consume five percent less alcohol than those lacking the gene, researchers at the Genome Center of the University of Tartu confirmed.

Science Daily (Finland) - Effects of a Large Reduction in Alcohol Prices on Mortality in Finland

Does a reduction in the price of alcohol result in an increase in deaths due to alcohol? This was the subject of a study following a significant reduction in taxes in Finland in 2004 (30% for spirits, 3% for wine).

Helsinki Times (Finland) - Strict alcohol policy under the microscope

Policy makers and social researchers in Finland are re-examining the politics of alcohol and other drugs in an effort to determine whether the country’s strict measures are doing more harm than good.

Active (Denmark) - Copenhagen’s bars willingly sold alcohol to 15-year old Swedes

The work of young members of UNF, The Swedish Youth Temperance Association, reveals the actual strength of actions by the alcohol industry in the European Alcohol and Health Forum. Young UNF members from Sweden’s border regions to Denmark went to Copenhagen to conduct mystery shopping and the results give a clear signal: of in total 7 tested bars and pubs, Swedish minors were without problems able to buy alcohol 11 times. 4 out of these 7 places are part of a project of City of Copenhagen and the alcohol industry.

The Baltic Course (Latvia) - Saeima supports increasing excise tax on alcohol, gasoline and cigarettes in Latvia

Today, Latvian Saeima supported in principle in the first reading an increase in the excise tax on liquor, cigarettes and gasoline. According to the amendments, the excise duty for liquor will be increased from LVL 890 to LVL 940 per 100 liters of pure alcohol.

BusinessWeek (USA) - Only 1.2% of Alcohol Abusers Know They Need Help: Report

A new report reveals that 98.8 percent of the more than 7.4 million American adults aged 21 to 64 with untreated alcohol abuse disorders don't believe they need treatment.

U.S. News & World Report - Early Response to Alcohol May Predict Later Drinking Behavior

A young adult's early response to alcohol may predict future drinking problems, researchers say.

MyHealthNewsDaily - Heavy Beer Drinkers Increase Their Gastric Cancer Risk

People who drink two to three beers a day for many years have a 75 percent increased risk of gastric cancer, and those who have the gene variant called rs1230025 but aren't heavy drinkers have a 30 percent higher risk of gastric cancer, compared with people who drank less than a beer daily, the study showed.

The Guardian (UK) - Young drinkers need more help, say campaigners

Every Friday and Saturday night brings the same scene in the A&E unit of the Royal Sussex county hospital in Brighton: a handful of teenage drunks who need attention.

Telegraph.co.uk - Glass or two of wine a week 'could damage baby'

Pregnant women who drink as little as a glass of wine a week could be putting their babies at risk, according to new research which contracts recent studies indicating that an occasional tipple is harmless.

The Australian (Australia) - Discount alcohol serves nobody: Gooda

ABORIGINAL and Torres Strait Islander Social Justice Commissioner Mick Gooda has called for even tougher alcohol laws than those proposed for Alice Springs, including legislation to introduce a "floor price" on alcohol at the price of full-strength beer in a bid to stop discounting.

Morning Advertiser (Scotland) - Scottish MPs clash on minimum pricing

Scottish politicians have clashed once again about introducing a minimum price on alcohol. The Scottish National Party (SNP) has vowed to revive its failed campaign to introduce a minimum price for alcohol after Labour, Conservatives and Lib Dems voted against the proposals for a 45p minimum price in November last year.

UPI.com (Italy) - Study: Italian youth at alcohol risk

The country's Higher Health Institute released a report Thursday saying at-risk drinkers of both sexes under the age of 16 are on the rise, with 18.5 percent of males and 15.5 percent of females in that age bracket showing worrying drink patterns, ANSA reported.

ABC Online (Australia) - Pregnant women could face ban on buying alcohol

An Aboriginal corporation in Central Australia says it wants to be allowed to ban pregnant women from buying alcohol.

The Canadian Press (Thailand) - Booze-free safe zones set up to curb drunken violence during upcoming Thai New Year

Sixty alcohol-free "safety areas" will be designated nationwide during Thailand's traditional New Year celebrations to decrease violence and sexual assaults that result from drunken revelry, health authorities said Friday.

Irish Times (Ireland) - Health warnings to be put on alcoholic drink cans, bottles

THE GOVERNMENT is preparing legislation that could see manufacturers of wines, beers and spirits forced to print stark warnings of the dangers of over-consumption of alcohol on bottles, cans and all promotional material.

NDTV.com - Gastric bypass patients take longer to process alcohol

Gastric bypass patients take longer to process alcohol, which could put some at risk for overdrinking. Gastric bypass surgery - an operation in which the surgeon staples a large section of the stomach, leaving only a tiny pouch - is used to help severely obese people lose weight.

Herald Scotland (Scotland) - Anger as court agrees garage alcohol sales

Campaigners have attacked a landmark judgment that will allow motorists to buy alcohol as they fill up their cars with fuel in towns and cities across Scotland.

The Guardian (Poland) - Debunking Polish stereotypes: A nation of vodkaholics

The history of vodka is inseparable from the history of Poland. Asking where exactly it originated is the easiest way of stirring up a fight between a Pole and a Russian. Suffice to say that the distillation of grain alcohol started somewhere in north-eastern Europe in the 8th or 9th century and that the word vodka ("little water") began to be used in Poland in the 15th century.

Whitman Pioneer (UK) - The public house culture of Britain encourages excessive drinking

One of the most significant differences, at least in terms of my day-to-day life, between the UK and the United States is that the drinking age in the UK is 18 as opposed to the United States’ 21.

Superbike Magazine (EU) – European Drink Driving Statistics

Drink-drivers are one of a biker’s worst enemies, especially at christmas when they go together like Morecambe and Wise. But who are the worst in Europe? The boozy French? Crazy Polacks? You might be surprised...

Read Full Newsletter

Binge Drinking +/– Chronic Nicotine Administration Alters Extracellular Glutamate and Arginine Levels in the Nucleus Accumbens of Adult Male and Female Wistar Rats

The effect of ‘binge drinking’ coupled or not with chronic nicotine administration on nucleus accumbens (NAc) glutamate, arginine, taurine and hydroxyl radical levels has been investigated in these present studies.

Ethanol, 2 or 3 g/kg, has been administered to male or female adult rats in a ‘binge-type’ regime for 3 weeks, +/– nicotine, and changes in glutamate, arginine and taurine content in the NAc, assayed by microdialysis after a further dose of ethanol.

The basal concentration of NAc glutamate increased 8-fold in the female adult rats but did not change significantly after further doses of ethanol. In contrast, the male adult rats showed no changes in basal glutamate content but exhibited a dose-dependent increase in NAc glutamate after further doses of ethanol. NAc arginine basal levels decreased significantly in both male and female adult rats after further doses of ethanol.

Co-administration of nicotine modified the toxicity of ethanol as exemplified by diminishment of both the basal NAc glutamate release as well as modifying the release of this excitatory amino acid after further ethanol doses, particularly in female rats.

In addition, the marked changes in arginine release after further ethanol doses were less evident.

There was no evidence for increased hydroxyl radical production in the NAc after ‘binge drinking’ +/– nicotine.

There appeared to be a greater vulnerability to ethanol toxicity in female adult rats after ‘binge drinking’. It remains unclear whether the increased release of glutamate during the microdialysis evokes activation of inducible nitric oxide synthase (iNOS), which would utilize arginine in the formation of nitric oxide.

Read Full Abstract

Request Reprint E-Mail: lallemandf@gmail.com

Investigating Ethnic Differences in Adolescent Alcohol Use and Peer Norms using Semi-Continuous Latent Growth Models

To investigate whether ethnic differences in vulnerability to peer norms supportive of alcohol use is a viable, partial explanation for the ethnic differences in reported prevalence and amount of alcohol use during high school.

Survey data from a sample of 680 adolescents from Project STAR (Students Taught Awareness and Resistance) of the Midwestern Prevention Project were used. Hypotheses were tested using sequential, semi-continuous growth curve models.

Relative to Black adolescents, White adolescents reported greater peer alcohol use during middle school and were much more likely to consume alcohol during high school. General peer norms in seventh grade and middle school growth in alcohol use norms among close friends was predictive of a greater propensity to consume alcohol in ninth grade among White adolescents.

Lower peer norms for alcohol use among Black adolescents might better account for differences between Black and White adolescents than the possibility that White adolescents are more vulnerable to peer norms.

Read Ful Abstract

Request Reprint E-Mail: srweaver@gsu.edu

Invertebrate Models of Alcoholism

For invertebrates to become useful models for understanding the genetic and physiological mechanisms of alcoholism related behaviors and the predisposition towards alcoholism, several general requirements must be fulfilled.

The animal should encounter ethanol in its natural habitat, so that the central nervous system of the organism will have evolved mechanisms for responding to ethanol exposure. How the brain adapts to ethanol exposure depends on its access to ethanol, which can be regulated metabolically and/or by physical barriers.

Therefore, a model organism should have metabolic enzymes for ethanol degradation similar to those found in humans. The neurons and supporting glial cells of the model organism that regulate behaviors affected by ethanol should share the molecular and physiological pathways found in humans, so that results can be compared.

Finally, the use of invertebrate models should offer advantages over traditional model systems and should offer new insights into alcoholism-related behaviors.

In this review we will summarize behavioral similarities and identified genes and mechanisms underlying ethanol-induced behaviors in invertebrates.

This review mainly focuses on the use of the nematode Caenorhabditis elegans, the honey bee Apis mellifera and the fruit fly Drosophila melanogaster as model systems.

We will discuss insights gained from those studies in conjunction with their vertebrate model counterparts and the implications for future research into alcoholism and alcohol-induced behaviors.

Read Full Abstract

Request Reprint E-Mail: hscholz2@uni-koeln.de.

Alcohol-attributable burden of disease and injury in Canada, 2004

This analysis aimed to estimate the burden of disease and injury caused and prevented by alcohol in 2004 for Canadians aged 0–69 years and compare the effects of different magnitudes of adjustment of survey data on these estimates.

Alcohol indicators were obtained from the Canadian Alcohol and Drug Use Monitoring Survey 2008 and were corrected to 80% coverage using adult per capita recorded and unrecorded consumption. Risk relations were taken from meta-analyses. Estimates of burden of disease and injury were obtained from the World Health Organization.

In 2004, 4,721 (95% CI 1,432–8,150) deaths and 274,663 (95% CI 201,397–352,432) disability-adjusted life years lost (DALYs) of Canadians 0–69 years of age were attributable to alcohol. This represented 7.1% (95% CI 2.1–12.2%) of all deaths and 9.3% (95% CI 6.8–11.9%) of DALYs for this age range. The sensitivity analysis showed that the outcome estimates varied substantially based on the adjusted coverage rate.

More attention to burden of disease and injury statistics is required to accurately characterize alcohol-related harms. This burden is preventable and could be reduced by implementation of more effective policies.

Read Full Abstract

Request Reprint E-Mail: kevin.shield@utoronto.ca

The longitudinal effects of behavioral, health, and socio-demographic factors on body mass index among older Chinese adults

To examine the effects of behavioral, health, and socio-demographic factors on being overweight or obese among older Chinese adults.

This research uses panel data from the China Health and Nutrition Survey, which was designed to examine how social and economic transformation affected the health and nutritional status of residents. For these analyses, we used all available information on adults aged 60 years or older surveyed in 1997, 2000, 2004, and 2006 (N = 3,591). Body mass index (BMI) was dichotomized as normal (18.5–24.9 kg/m²) and overweight (25.0–29.9 kg/m²)/obese (≥30 kg/m²). Generalized estimating equations were used to estimate population-averaged (marginal) effects.

The combined prevalence of overweight or obese was approximately 33%. Moderate or heavy non-leisure physical activities (OR = 0.39; 95% CI = 0.32–0.49) and smoking (OR = 0.69; 95% CI = 0.57–0.84) decreased the odds of being overweight or obese, while drinking alcohol (OR = 1.25; 95% CI = 1.05–1.50) increased the odds. For individuals in all income levels, the amount of non-leisure physical activity strongly affected the BMI among the older Chinese adults.

Active lifestyle interventions may help counter what could otherwise be a growing obesity epidemic in China.

Read Full Abstract

Request Reprint E-Mail: snahn@srph.tamhsc.edu

Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure - retrospective cohort study in an urban obstetric population in Ireland

Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption.

A cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week), moderate (6-20 units per week) and high (> 20 units per week).

Of the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80), Irish nationality OR 16.5 (95% CI 14.9 to 18.3), private health care OR 5.83 (95% CI 5.38 to 6.31) and smoking OR 1.86 (95% CI 1.73 to 2.01). Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91) and illicit drug use OR 6.46 (95% CI 3.32 to 12.60). High consumption was associated with very preterm birth (< 32 weeks gestation) even after controlling for socio-demographic factors adjusted OR 3.15 (95% CI 1.26-7.88). Only three cases of Fetal Alcohol Syndrome were recorded (0.05 per 1000 total births), one each in the low, moderate and high consumption groups.

Public Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population.

Read Full Article (PDF)

Alcohol advertising works while alcohol education seems to have little effect

Alcohol advertising seeks to influence young people’s drinking habits while alcohol education programs appears not to have the same effect in preventing youth from drinking. This is the key result of a study from Zambia which was published recently. > > > > Read More

News and updates April 2011: Alcohol and cancer risk; move to restrict advertising; alcohol's cost to Wales; Royal Wedding licensing hours

Increased cancer risk with alcohol consumption highlighted

Research published in the BMJ has highlighted that around 10% of all cancers in men and 3% in women are attributable to alcohol consumption. Although the media reported increased risk of cancer even when drinking within the recommended guidelines, the BMJ highlighted risk to be proportionately greater on exceeding the guidelines. See an NHS Choices summary on the topic and reports from the Guardian, BBC, Telegraph and Cancer Research UK.

Calls to protect children from alcohol advertising

A call for a tougher stance on alcohol advertising in the UK has been given the backing of health experts. Dr Sarah Wollaston, a Conservative MP who has also called for minimum pricing, put forward a private members bill to limit the exposure of children to alcohol marketing. It calls for statutory regulation that outlaws marketing to children and ensures that information in ads is factual and verifiable, similar to laws passed in France. The move was backed by health experts writing in the BMJ, but drinks producer Diageo spoke out and claimed the evidence was unsubstantiated.

Obesity and alcohol misuse costs NHS £140m in Wales reports the BBC. The research put the cost of obesity to the NHS in Wales at £73m and excessive alcohol consumption at between £69.9m and £73.3m. See here for Independant report. > > > Read More

Sunday, April 10, 2011

Commentary on Boden & Fergusson "Alcohol and depression "

CLARIFYING THE RELATIONSHIP BETWEEN ALCOHOL AND DEPRESSION (pages 915–916)

KENNETH R. CONNER (PDF)

ALCOHOL USE DISORDERS AND DEPRESSION – THE CHICKEN OR THE EGG? (pages 916–918)

TRINE FLENSBORG-MADSEN

(PDF)

Alcohol and depression

To examine the literature on the associations between alcohol use disorders (AUD) and major depression (MD), and to evaluate the evidence for the existence of a causal relationship between the disorders.

PsycInfo; PubMed; Embase; Scopus; ISI Web of Science database searches for studies pertaining to AUD and MD from the 1980 to the present. Random-effects models were used to derive estimates of the pooled adjusted odds ratios (AOR) for the links between AUD and MD among studies reporting an AOR.

The analysis revealed that the presence of either disorder doubled the risks of the second disorder, with pooled AORs ranging from 2.00 to 2.09. Epidemiological data suggest that the linkages between the disorders cannot be accounted for fully by common factors that influence both AUD and MD, and that the disorders appear to be linked in a causal manner. Further evidence suggests that the most plausible causal association between AUD and MD is one in which AUD increases the risk of MD, rather than vice versa. Potential mechanisms underlying these causal linkages include neurophysiological and metabolic changes resulting from exposure to alcohol. The need for further research examining mechanisms of linkage, gender differences in associations between AUD and MD and classification issues was identified.

The current state of the literature suggests a causal linkage between alcohol use disorders and major depression, such that increasing involvement with alcohol increases risk of depression. Further research is needed in order to clarify the nature of this causal link, in order to develop effective intervention and treatment approaches.

Read Full Abstract

Request Reprint E-Mail: dm.fergusson@otago.ac.nz

Botswana alcohol policy and the presidential levy controversy

To assess the state of alcohol policy in Botswana in the context of a substantial levy imposed on alcohol sales by the President.

Analysis of policy documents and media reports to describe the drivers of policy formation.

Legislation aimed at addressing the problem of excessive consumption of alcohol in the country has been proposed and enacted since independence in 1966 and a draft national alcohol policy is currently being debated. The policy recognizes the need to protect the rights of adult citizens of Botswana to purchase and consume alcohol in a safe and well-regulated manner and the role of government in ensuring that vulnerable members of the community are protected against the impact of harmful use of alcohol. In 2008, controversy erupted over the proposal by the President of the country to impose a 70% levy on alcohol products, later reduced to 30%. The industry responded by threatening to go to court and has since focused their response on what they claim to be serious economic losses due to reduced consumption of their products.

The ongoing controversy in Botswana calls attention to the role of the industry in influencing the debate on alcohol and the need to keep in mind overall public health interest in efforts to develop and implement a national alcohol policy.

Read Full Abstract

Request Reprint E-Mail: pitsojmn@mopipi.ub.bw

Expanding the Framework of Treatment

293 In This Issue [PDF]

295 Advances in Alcoholism Treatment [PDF]
Robert B. Huebner with Lori Wolfgang Kantor

300 Medications for Unhealthy Alcohol Use: Across the Spectrum [PDF]
Stephanie S. O’Malley and Patrick G. O’Connor

313 Behavioral Therapy Across the Spectrum [PDF]
Katie Witkiewitz and G. Alan Marlatt

320 The Use of Emerging Technologies in Alcohol Treatment [PDF]
John A. Cunningham, Kypros Kypri, and Jim McCambridge

327 An E-Health Solution for People With Alcohol Problems [PDF]
David H. Gustafson, Michael G. Boyle, Bret R. Shaw, Andrew Isham, Fiona McTavish, Stephanie Richards, Christopher Schubert, Michael Levy, and Kim Johnson

338 Integrating Care for People With Co-Occurring Alcohol and Other Drug, Medical, and Mental Health Conditions [PDF]
Stacy Sterling, Felicia Chi, and Agatha Hinman

350 The Role of Mutual-Help Groups in Extending the Framework of Treatment [PDF]
John F. Kelly and Julie D. Yeterian

356 Treating Alcoholism As a Chronic Disease: Approaches to Long-Term Continuing Care [PDF]
James R. McKay and Susanne Hiller-Sturmhöfel

371 The Recovery Spectrum: From Self-Change to Seeking Treatment [PDF]
Jalie A. Tucker and Cathy A. Simpson

380 The Community Reinforcement Approach: An Update of the Evidence [PDF]
Robert J. Meyers, Hendrik G. Roozen, and Jane Ellen Smith

389 Health Services and Financing of Treatment [PDF]
Maureen T. Stewart and Constance M. Horgan

395 Index to Volume 33 [PDF]

Click here to download publication for Kindle
Click here to download publication for iPad and other readers
Click here to download publication in generic eBook format

Saturday, April 9, 2011

Commentaries on " Addiction and dependence in DSM-V " O'Brien (2011)

APPLYING AN INTERNATIONAL PUBLIC HEALTH PERSPECTIVE TO PROPOSED CHANGES FOR DSM-V (pages 868–870)VLADIMIR POZNYAK, GEOFFREY M. REED and NICOLAS CLARK (PDF)

SUBSTANCE, NOT SEMANTICS, IS THE ISSUE: COMMENTS ON THE PROPOSED ADDICTION CRITERIA FOR DSM-V (pages 870–872) THOMAS F. BABOR (PDF)

DSM-V: TIME FOR CHANGE (pages 872–873) WALTER LING (PDF)

A COMMENTARY ON ‘ADDICTION AND DEPENDENCE IN DSM-V’ (pages 873–874) ROGER E. MEYER (PDF)

A WELCOME CHANGE THAT STOPS SHORT OF BEING FULLY SATISFYING (pages 874–875) MARKUS HEILIG (PDF)

ADDICTION AND DEPENDENCE: MAKING REALITIES IN THE DSM (pages 875–877) HELEN KEANE, DAVID MOORE and SUZANNE FRASER (PDF)

DSM-5: EVIDENCE TRANSLATING TO CHANGE IS IMPRESSIVE (pages 877–878) MAREE TEESSON, TIM SLADE and LOUISE MEWTON (PDF)

LANGUAGE-USE DISORDER: COMMENT ON DSM-V'S PROPOSED ‘ADDICTION AND RELATED DISORDERS’ AND CHARLES O'BRIEN'S ‘ADDICTION AND DEPENDENCE IN DSM-V’ (pages 878–879) DAVID T. COURTWRIGHT     (PDF)

SUBSTANCE USE DISORDERS – A CONCEPTUAL AND TERMINOLOGICAL MUDDLE (pages 879–882) ROBIN ROOM    (PDF)

SUBSTANCE USE DISORDERS IN DSM-V WHEN APPLIED TO ADOLESCENTS (pages 882–884) KEN C. WINTERS, CHRIS S. MARTIN and TAMMY CHUNG
(PDF)

DIAGNOSING THE USE OF ILLEGAL DRUGS BY OLDER PEOPLE – COMMENTS ON THE PROPOSED CHANGES TO DSM-V (pages 884–885) CARYL BEYNON      (PDF)

THERE IS POTENTIAL FOR CULTURAL AND SOCIAL BIAS IN DSM-V (pages 885–887) RAUL CAETANO       (PDF)

IN SUPPORT OF SUBSTANCE USE DISORDERS (pages 887–888) MARÍA E. MEDINA MORA    (PDF)

NEW AND REMAINING PROBLEMS WITH DSM-V (pages 888–889) AMBROS UCHTENHAGEN     (PDF)

WHY DO WE CARE? NOTES FROM THE PERIPHERY (pages 889–891) KERSTIN STENIUS and JOHAN EDMAN (PDF)

DIAGNOSTIC ORPHANS (pages 891–892) RAJAT RAY and ANJU DHAWAN (PDF)

THE END OF THE DEPENDENCE SYNDROME AS WE KNOW IT? (pages 892–894) COLIN DRUMMOND
(PDF)

APPLICABILITY OF DSM CRITERIA TO NICOTINE DEPENDENCE (pages 894–895)

JOHN R. HUGHES, TIMOTHY BAKER, NAOMI BRESLAU, LIRIO COVEY and SAUL SHIFFMAN
(PDF)

RESPONSE TO COMMENTARIES (pages 895–897) CHARLES P. O'BRIEN (PDF)

Friday, April 8, 2011

Addiction and dependence in DSM-V

As preparations for the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) are under way, this paper focuses upon changes proposed for the substance use disorders section.

It briefly outlines the history behind the current nomenclature, and the selection of the term ‘dependence’ over ‘addiction’ in earlier versions of the DSM.

The term ‘dependence’, while used in past decades to refer to uncontrolled drug-seeking behavior, has an alternative meaning—the physiological adaptation that occurs when medications acting on the central nervous system are ingested with rebound when the medication is abruptly discontinued.

These dual meanings have led to confusion and may have propagated current clinical practices related to under-treatment of pain, as physicians fear creating an ‘addiction’ by prescribing opioids.

In part to address this problem, a change proposed for DSM-V is to alter the chapter name to ‘Addiction and Related Disorders’, which will include disordered gambling.

The specific substance use disorders may be referred to as ‘alcohol use’ or ‘opioid use’ disorders. The criteria for the disorders are likely to remain similar, with the exception of removal of the ‘committing illegal acts’ criterion and addition of a ‘craving’ criterion. The other major change relates to the elimination of the abuse/dependence dichotomy, given the lack of data supporting an intermediate stage.

These changes are anticipated to improve clarification and diagnosis and treatment of substance use and related disorders.

Read Full Abstract

Request Reprint E-Mail: obrien@mail.trc.upenn.edu

Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study.

Combination of prospective cohort study with representative population based data on alcohol exposure.

Eight countries (France, Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Denmark) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

109 118 men and 254 870 women, mainly aged 37-70.

Hazard rate ratios expressing the relative risk of cancer incidence for former and current alcohol consumption among EPIC participants. Hazard rate ratios combined with representative information on alcohol consumption to calculate alcohol attributable fractions of causally related cancers by country and sex. Partial alcohol attributable fractions for consumption higher than the recommended upper limit (two drinks a day for men with about 24 g alcohol, one for women with about 12 g alcohol) and the estimated total annual number of cases of alcohol attributable cancer.

If we assume causality, among men and women, 10% (95% confidence interval 7 to 13%) and 3% (1 to 5%) of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries. For selected cancers the figures were 44% (31 to 56%) and 25% (5 to 46%) for upper aerodigestive tract, 33% (11 to 54%) and 18% (−3 to 38%) for liver, 17% (10 to 25%) and 4% (−1 to 10%) for colorectal cancer for men and women, respectively, and 5.0% (2 to 8%) for female breast cancer. A substantial part of the alcohol attributable fraction in 2008 was associated with alcohol consumption higher than the recommended upper limit: 33 037 of 178 578 alcohol related cancer cases in men and 17 470 of 397 043 alcohol related cases in women.

Read Full Article (PDF)

Aims

Monday, April 11, 2011

Sunday, April 10, 2011

Saturday, April 9, 2011

Friday, April 8, 2011