Balancing Environmental and Genetic Factors for Alcoholism in the Black Community: Implications for Social Work Practice

This article discusses the importance and relevance of balancing environmental and genetic factors for understanding alcoholism in the Black community. Studies are reviewed and myths dispelled to highlight the need for addressing the historical complexities and current challenges of alcoholism for Blacks. Suggestions for practice, research, and policy at the genetic and environmental levels are offered.


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Request Reprint E-Mail: csnell@howard.edu

Policymakers mull EU alcohol marketing law

Alcohol consumption among young people increases as a result of advertising campaigns and the EU should promote more responsible marketing, stakeholders agreed this week. But responsibility for dealing with the issue lies with member states and the European Commission has no intention of harmonising legislation in this regard. > > > > Read More

Work and High-Risk Alcohol Consumption in the Canadian Workforce

This study examined the associations between occupational groups; work-organization conditions based on task design; demands, social relations, and gratifications; and weekly high-risk alcohol consumption among Canadian workers. A secondary data analysis was performed on Cycle 2.1 of the Canadian Community Health Survey conducted by Statistics Canada in 2003.

The sample consisted of 76,136 employees 15 years of age and older nested in 2,451 neighbourhoods. High-risk alcohol consumption is defined in accordance with Canadian guidelines for weekly low-risk alcohol consumption.

The prevalence of weekly high-risk alcohol consumption is estimated to be 8.1% among workers. The results obtained using multilevel logistic regression analysis suggest that increased work hours and job insecurity are associated with elevated odds of high-risk alcohol consumption.

Gender female, older age, being in couple and living with children associated with lower odds of high-risk drinking, while increased education, smoking, physical activities, and, and economic status were associated with higher odds.

High-risk drinking varied between neighbourhoods, and gender moderates the contribution of physical demands.

The results suggest that work made a limited contribution and non-work factors a greater contribution to weekly high-risk alcohol consumption. Limits and implications of these results are discussed.


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Press Release - Adolescent Substance Use: America’s #1 Public Health Problem

Nine out of 10 Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18, according to a national study released today by The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

Adolescent Substance Use: America’s #1 Public Health Problem reveals that adolescence is the critical period for the initiation of substance use and its consequences. The CASA report finds 1 in 4 Americans who began using any addictive substance before age 18 are addicted, compared to 1 in 25 Americans who started using at age 21 or older. > > > > Read More

Adolescent Substance Use: America’s #1 Public Health Problem

This report documents the nature and origin of the largest preventable--and most costly-- health problem in America. It reveals the latest information about how substance use and addiction affect the teen brain and neurochemistry; lays out the extent of the problem of teen substance use and addiction; and describes the health, safety and social consequences. It examines the broad factors within American culture that drive adolescent substance use and explores the range of individual factors that compounds these risks for many vulnerable teens. It summarizes what research demonstrates can be done to prevent and reduce the problem; describes the chasm between this knowledge and what health care providers, parents, schools, communities and policymakers are actually doing; and explores the barriers to bridging this gap and implementing effective substance use prevention and control policies. Finally, it provides concrete and evidence-based recommendations for health care professionals, parents, policymakers, educators, the media, researchers and teens themselves to act in the face of the body of knowledge presented in this report.



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Suicide and Homicide in Northern Ireland

Overall, 1,865 suicides occurred in Northern
Ireland in the period 2000-2008, 207 per year,
giving a general population annual suicide
rate of 13.9 per 100,000 people. This rate is
higher than in the United Kingdom as a whole,
though lower than in Scotland. The suicide
rate in Northern Ireland rose in the later part of
the report period, in contrast to the rest of the
United Kingdom. This period includes the first
two years after the publication of the Protect Life
Suicide Prevention Strategy, though it is too early
to comment on the effectiveness of the Strategy.

We identified 142 homicide convictions during
2000-2008, 16 per year, though this is likely to
be an underestimate. The equivalent annual
homicide rate is 10.6 per million people, similar
to the rate in England and Wales but lower than
the rate in Scotland. Alcohol and drug misuse High rates of substance misuse and dependence run through this report and, as we rely on information known to clinicians, our figures are likely to underestimate the problem. Alcohol misuse, in particular, was a common feature of patient suicide (60%), and appears to have become more common. Alcohol dependence was the most common clinical diagnosis (52%) in patients convicted of homicide and, in homicide generally, alcohol misuse was a more common feature in Northern Ireland than in the other UK countries. Dual diagnosis (severe mental illness and alcohol or drug misuse) was found in 1 in 4 patient suicides. Clinicians regarded better services for dual diagnosis as an important step towards reducing risk.


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Prevalence of Alcohol Use and Associated Factors in Urban Hospital Outpatients in South Africa

The aim of this study was to assess the prevalence of alcohol use and associated factors among outpatients in an urban hospital in South Africa.

The sample included 1,532 (56.4% men and women 43.6%) consecutively selected patients from different hospital outpatient departments.

Results indicate that 41.2% of men and 18.3% of women were found to be hazardous drinkers, and 3.6% of men and 1.4% of women meet criteria for probable alcohol dependence or harmful drinking as defined by the Alcohol Use Disorder Identification Test (AUDIT).

Two in five patients (40.5%) were hazardous or harmful drinkers and/or had anxiety or depression.

Logistic multiple regression found that for men tobacco use and not having been diagnosed with diabetes and for women tobacco use and having been diagnosed with migraine headache was associated with hazardous and harmful drinking.

Although the study is cross-sectional, it does identify groups that may be at high risk of alcohol misuse and for whom intervention is urgent.

Because prevalence of hazardous and harmful alcohol use is high in this population, routine screening should be introduced in hospital out-patient settings.


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Intoxicated workers: findings from a national Australian survey

To identify prevalence of alcohol and drug use and intoxication at work.

A total of 9828 Australian workers ≥14 years old.

Australia 2007.

Work-place alcohol use and drug use, intoxication at work, industry and occupation of employment.

Secondary analysis of a large nationally representative survey involving descriptive and +weighted multivariate logistic regressions.

Differential patterns were identified by drug type, worker characteristics and occupational setting, controlling for demographic variables. Nearly 9% of workers surveyed (8.7%) usually drank alcohol at work and 0.9% usually used drugs at work. Attending work under the influence of alcohol was more prevalent (5.6%) than attending work under the influence of drugs (2.0%), and significantly more likely among young, male, never married workers with no dependent children. Hospitality industry workers were 3.5 times more likely than other workers to drink alcohol and two to three times more likely to use drugs at work or attend work under the influence of alcohol or drugs. Other high-risk industries and occupations included construction, financial services, tradespersons and unskilled workers.

More than one in 20 Australian workers admit to having worked under the influence of alcohol and almost one in 50 report attending work under the influence of psychoactive drugs. The rates are higher for some industries, such as the hospitality industry, than others.

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Request Reprint E-Mail: ken.pidd@flinders.edu.au

Associations of corticosterone and testosterone with alcohol drinking in F2 populations derived from AA and ANA rat lines

In our previous studies on alcohol-preferring AA (Alko alcohol) and nonpreferring ANA (Alko nonalcohol) rats, we have observed that the AA rats exhibit lower endogenous levels of corticosterone, higher testosterone levels, and more frequent alcohol-induced testosterone elevations when compared with ANA rats.

The objective of the present study was to get more conclusive evidence for the potential role of the hypothalamus–pituitary–adrenal and hypothalamus–pituitary–gonadal axes in alcohol drinking by using the F2 experimental design.

Alcohol-preferring AA and alcohol-nonpreferring ANA rat lines were crossbred to form a F1 population from which the final F2 population was derived. Male animals were challenged with a priming alcohol dose after which a 3 weeks’ voluntary alcohol drinking period took place. After a washout period of 1 week, one-half of the 40 highest and 40 lowest alcohol drinkers were challenged with a second dose of alcohol and the other half with saline. Serum testosterone and corticosterone levels were measured before and during the test.

Higher endogenous testosterone levels were detected in the rats of the high alcohol consumption group compared with the low consumption group. Also supporting the original AA/ANA line differences, a trend for lower endogenous corticosterone levels were measured in the high alcohol consumption group compared with the low consumption group.

The alcohol challenge test after the drinking period resulted in a higher frequency (38%) of testosterone elevations in the high drinkers compared with the low drinkers (5%).

The present data confirms the validity of the positive connections between testosterone elevation and increased alcohol drinking, as well as between testosterone reduction and decreased alcohol drinking, in AA and ANA rats.

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Homeless alcoholics drink in comfort at 'wet houses'

Critics call Anishinabe Wakiagun a place of death, but to its 45 residents, one of whom has been here 11 years, it is more like a lifeline.

One resident of the People's House wheels a bicycle down an upstairs corridor, cursing as he goes.

A few doors along, drinking buddies get rowdy over a bottle of cherry vodka. And downstairs, a sign on the outside security door warns against bringing firearms inside.

The Minneapolis area's three wet houses vary in approach but all share one common - and controversial - feature: within these walls, no-one stops you drinking. > > > > Read More

National Admissions to Substance Abuse Treatment Services: 1999-2009

Shows trends in substance abuse treatment admissions over a 10-year period, 1999-2009. Gives statistics on major substance of abuse, teen substance abuse, polydrug abuse, ethnicity, socioeconomic status, age, and state or region.

Alcohol

• Alcohol admissions declined steadily from 48 percent of admissions aged 12 and older in 1999 to 39 percent in 2005, but then increased steadily to 42 percent in 2009. In 2009, 44 percent of primary alcohol admissions aged 12 and older reported secondary drug abuse as well [Table 1.1b].
• Admissions for abuse of alcohol alone represented 23 percent of TEDS admissions aged 12 and older in 2009, while admissions for primary alcohol abuse with secondary drug abuse represented 18 percent¹ [Table 1.1b].
• Almost three-quarters of admissions for abuse of alcohol alone and for abuse of alcohol with secondary drug abuse were male (73 percent each) [Table 2.1a].
• The average age at admission among alcohol-only admissions was 40 years compared with 36 years among admissions for primary alcohol with secondary drug abuse [Table 2.1a].
• More than two-thirds (68 percent) of alcohol-only admissions were non-Hispanic White, followed by admissions of Hispanic origin (13 percent) and non-Hispanic Blacks (12 percent). Among admissions for alcohol with secondary drug abuse, 59 percent were non-Hispanic White, followed by 23 percent who were non-Hispanic Black and 11 percent who were of Hispanic origin [Table 2.2].

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Zambia: An alcohol policy alliance in the making?

In his presentation at the meeting Dr John Mayaya from the Ministry of Health (picture to the right) stressed the important role of NGOs in alcohol policy discussions. He said that governments need NGOs both as watchdogs, as strong voices for public health interests and as partners in mobilizing stakeholders.

Dr Mayeya presented the new Liquor Act which had just been adopted by the Zambian parliament. This Act will be followed by a new alcohol policy which is soon to be presented and adopted. The new policy, however, has been developed without any broad participation from the civil society of Zambia. Dr. Mayeya therefore invited all the present NGOs to submit their opinions on the policy shortly after the workshop. He also welcomed the fact that a network of NGOs concerned with alcohol policies now seemed to be emerging in Zambia.
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Critique 045: Alcohol drinking in the elderly: Risks and benefits – 26 June 2011

The Royal College of Psychiatrists of London has published a report related primarily to problems of unrecognized alcohol misuse among the elderly. The report provides guidelines for psychiatrists and family physicians on how to find and how to treat elderly people with misuse of alcohol and drugs.

A few pages of the lengthy report concern the evidence base for a proposed reduction of sensible limits of alcohol intake for older people. Forum reviewers of the report point out inherent difficulties in providing drinking guidelines for a very non-homogenous group of individuals whose only criterion for inclusion is being above the age of 65 years. Such individuals vary from marathon runners to very sick, frail people. Reviewers thought that advice to lower “acceptable” levels of drinking for everyone in this age group was not appropriate and not based on reliable research.

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News Release - UC Study Reveals Possible Brain Damage in Young Adult Binge-Drinkers

It’s considered a rite of passage among young people – acting out their independence through heavy, episodic drinking. But a new University of Cincinnati study, the first of its kind nationally, is showing how binge drinking among adolescents and young adults could be causing serious damage to a brain that’s still under development at this age.

Researcher Tim McQueeny, a doctoral student in the UC Department of Psychology, is presenting the findings this week at the 34th annual meeting of the Research Society on Alcoholism in Atlanta.

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Alcohol Use and Problem Severity: Associations With Dual Systems of Self-Control

The current study tested the associations between a dual-systems model of self-control and alcohol use and problem severity.

The sample consisted of 491 college students (77.0% women) from a rural state university. Participants completed a series of online surveys that assessed aspects of self-control, alcohol consumption, and alcohol-related problems.

A confirmatory factor analysis model indicated two moderately correlated factors of poor control and good self-control. Poor control was positively associated with both alcohol use and problem severity. Good self-control had a negative association with problem severity. Good self-control moderated the association between poor control and alcohol use as well as between poor control and problem severity. The association between poor control and alcohol use was stronger at low levels of good self-control, whereas at high levels of good self-control, the effect of poor control was weaker and not significant. The interaction predicting problem severity was different: There was a negative association between good self-control and problem severity at low levels of poor control, and this effect diminished as poor control increased.

The results suggest that multidimensional models of self-control may be useful in understanding problematic alcohol use and may be beneficial for prevention and intervention efforts.



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Request Reprint E-Mail: jsimons@usd.edu

A Longitudinal Examination of Alcohol Pharmacotherapy Adoption in Substance Use Disorder Treatment Programs: Patterns of Sustainability and Discontinu

The objectives of this study were to (a) identify the patterns of disulfiram (Antabuse) and tablet naltrexone (Revia) adoption over a 48-month period in a nationally representative sample of privately funded programs that deliver substance use disorder treatment; (b) examine predictors of sustainability, later adoption, discontinuation, and nonadoption of disulfiram and tablet naltrexone; and (c) measure reasons for medication discontinuation.

Two waves of data were collected via face-to-face structured interviews with 223 program administrators.

These data demonstrated that adoption of medications for alcohol use disorders (AUDs) was a dynamic process. Although nonadoption was the most common pattern, approximately 20% of programs sustained use of the AUD medications and 30% experienced organizational change in adoption over the study period. Bivariate multinomial logistic regression models revealed that organizational characteristics were associated with sustainability including location in a hospital setting, program size, accreditation, revenues from private insurance, referrals from the criminal justice system, number of medical staff, and use of selective serotonin reuptake inhibitors at baseline. Two patterns of discontinuation were found: Programs either discontinued use of all substance use disorder medications or replaced disulfiram/tablet naltrexone with a newer AUD medication.

These findings suggest that adoption of AUD medications may be positively affected by pressure from accreditation bodies, partnering with primary care physicians, medication-specific training for medical staff, greater availability of resources to cover the costs associated with prescribing AUD medications, and amending criminal justice contracts to include support for AUD medication use.



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Request Reprint E-Mail: proman@uga.edu

Six-Month Changes in Spirituality and Religiousness in Alcoholics Predict Drinking Outcomes at Nine Months

Although spiritual change is hypothesized to contribute to recovery from alcohol dependence, few studies have used prospective data to investigate this hypothesis. Prior studies have also been limited to treatment-seeking and Alcoholics Anonymous (AA) samples. This study included alcohol-dependent individuals, both in treatment and not, to investigate the effect of spiritual and religious (SR) change on subsequent drinking outcomes, independent of AA involvement.

Alcoholics (N = 364) were recruited for a panel study from two abstinence-based treatment centers, a moderation drinking program, and untreated individuals from the local community. Quantitative measures of SR change between baseline and 6 months were used to predict 9-month drinking outcomes, controlling for baseline drinking and AA involvement.

Significant 6-month changes in 8 of 12 SR measures were found, which included private SR practices, beliefs, daily spiritual experiences, three measures of forgiveness, negative religious coping, and purpose in life. Increases in private SR practices and forgiveness of self were the strongest predictors of improvements in drinking outcomes. Changes in daily spiritual experiences, purpose in life, a general measure of forgiveness, and negative religious coping also predicted favorable drinking outcomes.

SR change predicted good drinking outcomes in alcoholics, even when controlling for AA involvement. SR variables, broadly defined, deserve attention in fostering change even among those who do not affiliate with AA or religious institutions. Last, future research should include SR variables, particularly various types of forgiveness, given the strong effects found for forgiveness of self.



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Request Reprint E-Mail: earrobin@umich.edu

Neighborhood Variation in Adolescent Alcohol Use: Examination of Socioecological and Social Disorganization Theories

Risk factors for adolescent alcohol use are typically conceptualized as individual and interpersonal level factors; however, these factors do not fully explain adolescent drinking behavior. We used a socioecological model to examine the contribution of neighborhood factors in a risk and promotive model of adolescent alcohol use among urban high school youth (N = 711; 52% female; 82% African American; M = 18 years old).

Using a multilevel model, we considered the role of neighborhood disadvantage on youth alcohol use, after accounting for risk (e.g., peer and parental substance use) and promotive factors (e.g., social support and participation in prosocial activities).

Peer alcohol use and peer support were associated with more alcohol use, and maternal support was negatively associated with alcohol use. Despite significant variation at the neighborhood level, neighborhood disadvantage was not directly associated with adolescent drinking.

Our study contributes to a mixed ody of literature on social context and adolescent health. Although our research highlights the importance of interpersonal relationships, we found no support for neighborhood influences. We conclude with future directions for research examining the link between adolescent drinking and neighborhood contexts



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Request Reprint E-Mail: marcz@umich.edu

Effects of AlcoholEdu for College on Alcohol-Related Problems Among Freshmen: A Randomized Multicampus Trial

AlcoholEdu for College is a 2- to 3-hour online course for incoming college freshmen. This study was the first multicampus trial to examine effects of AlcoholEdu for College on alcohol-related problems among freshmen.

Thirty universities participated in the study. Fifteen were randomly assigned to receive AlcoholEdu, and the other 15 were assigned to the control condition. AlcoholEdu was implemented by intervention schools during the summer and/or fall semester. Cross-sectional surveys of freshmen were conducted at each university beginning before the intervention in spring 2008/2009; post-intervention surveys were administered in fall 2008/2009 and spring 2009/2010. The surveys included questions about the past-30-day frequency of 28 alcohol-related problems, from which we created indices for the total number of problems and problems in seven domains: physiological, academic, social, driving under the influence/ riding with drinking drivers, aggression, sexual risk taking, and victimization. Multilevel Poisson regression analyses were conducted to examine intent-to-treat and dosage effects of AlcoholEdu for College on these outcomes.

Multilevel intent-to-treat analyses indicated significant reductions in the risk for past-30-day alcohol problems in general and problems in the physiological, social, and victimization domains during the fall semester immediately after completion of the course. However, these effects did not persist in the spring semester. Additional analyses suggested stronger AlcoholEdu effects on these outcomes at colleges with higher rates of student course completion. No AlcoholEdu effects were observed for alcohol-related problems in the other four domains.

AlcoholEdu for College appears to have beneficial short-term effects on victimization and the most common types of alcohol-related problems among freshmen. Universities may benefit the most by mandating AlcoholEdu for College for all incoming freshmen and by implementing this online course along with environmental prevention strategies.



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Request Reprint E-Mail: paschall@prev.org

WHO release guide to developing alcohol regulation

The World Health Organization (WHO) have released Government guidance on alcohol regulation:

Addressing the harmful use of alcohol - a guide to developing effective alcohol regulation

The guide is to 'assist government agencies and ministries in developing country-level legislation to implement, monitor and enforce effective alcohol policies'. It provides 'practical advice based on international experience about the implications of legislative options, steps to be taken to implement legislation and best practice on how to enforce legislation and support compliance'. > > > > Read More